Apolipoprotein A-IV: a protein intimately involved in metabolism

J Lipid Res. 2015 Aug;56(8):1403-18. doi: 10.1194/jlr.R052753. Epub 2015 Feb 1.

Abstract

The purpose of this review is to summarize our current understanding of the physiological roles of apoA-IV in metabolism, and to underscore the potential for apoA-IV to be a focus for new therapies aimed at the treatment of diabetes and obesity-related disorders. ApoA-IV is primarily synthesized by the small intestine, attached to chylomicrons by enterocytes, and secreted into intestinal lymph during fat absorption. In circulation, apoA-IV is associated with HDL and chylomicron remnants, but a large portion is lipoprotein free. Due to its anti-oxidative and anti-inflammatory properties, and because it can mediate reverse-cholesterol transport, proposed functions of circulating apoA-IV have been related to protection from cardiovascular disease. This review, however, focuses primarily on several properties of apoA-IV that impact other metabolic functions related to food intake, obesity, and diabetes. In addition to participating in triglyceride absorption, apoA-IV can act as an acute satiation factor through both peripheral and central routes of action. It also modulates glucose homeostasis through incretin-like effects on insulin secretion, and by moderating hepatic glucose production. While apoA-IV receptors remain to be conclusively identified, the latter modes of action suggest that this protein holds therapeutic promise for treating metabolic disease.

Keywords: chylomicron; diabetes; glucose tolerance; incretins; intestinal lipid transport; lymph fistula mouse model; obesity.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Animals
  • Apolipoproteins A / metabolism*
  • Bariatric Surgery
  • Gene Expression Regulation
  • Humans
  • Metabolism*

Substances

  • Apolipoproteins A
  • apolipoprotein A-IV