Cholesterol crystal explained

A cholesterol crystal is a solid, crystalline form of cholesterol found in gallstones and atherosclerosis. Gallstones occurring in industrialized societies typically contain more than 70-90% cholesterol by weight, much of which is crystalline.^[1] Cholesterol crystals are a hallmark of atherosclerosis, which is believed to be an early cause of atherosclerotic inflammation.^[2] Cholesterol phase transition from liquid to crystalline form is linked to inflammation.^[3] Cholesterol crystals are believed to induce inflammation by activation of the NLRP3 inflammasome.^{[4] [5]}

In addition to being a source of inflammation, cholesterol crystals are believed to cause mechanical injury by tearing tissue, causing plaque rupture.^[6] Impaired removal of cholesterol crystals from demyelinated nerves by macrophages is believed to be associated with multiple sclerosis, and this remyelination failure is particularly impaired in the elderly.^{[7] [8]}

Notes and References

1. Dowling RH . Review: pathogenesis of gallstones . . 14 . Suppl 2 . 39–47 . 2000 . 10903002 . 10.1046/j.1365-2036.2000.014s2039.x . 32902101 . free .
2. Duewell P, Kono H, Rayner KJ, Sirois CM, Vladimer G, Bauernfeind FG, Abela GS, Franchi L, Nuñez G, Schnurr M, Espevik T, Lien E, Fitzgerald KA, Rock KL, Moore KJ, Wright SD, Hornung V, Latz E . NLRP3 inflammasomes are required for atherogenesis and activated by cholesterol crystals . . 464 . 7293 . 1357–1361 . 2010 . 10.1038/nature08938 . 20428172 . 2946640 . 2010Natur.464.1357D .
3. Grebe A, Latz E . Cholesterol crystals and inflammation . Current Rheumatology Reports . 15 . 3 . 313 . 2013 . 10.1007/s11926-012-0313-z . 23412688 . 3623938 .
4. Ridker PM . From C-Reactive Protein to Interleukin-6 to Interleukin-1: Moving Upstream To Identify Novel Targets for Atheroprotection . . 118 . 1 . 145–156 . 2016 . 10.1161/CIRCRESAHA.115.306656 . 4793711 . 26837745 .
5. Libby P . Interleukin-1 Beta as a Target for Atherosclerosis Therapy: Biological Basis of CANTOS and Beyond . . 70 . 18 . 2278–2289 . 2017 . 10.1016/j.jacc.2017.09.028 . 5687846 . 29073957 .
6. Abela GS, Kalavakunta JK, Janoudi A, Leffler D, Dhar G, Salehi N, Cohn J, Shah I, Karve M, Kotaru V, Gupta V, David S, Narisetty KK, Rich M, Vanderberg A, Pathak DR, Shamoun FE . Frequency of Cholesterol Crystals in Culprit Coronary Artery Aspirate During Acute Myocardial Infarction and Their Relation to Inflammation and Myocardial Injury . . 120 . 10 . 1699–1707 . 2017 . 10.1016/j.amjcard.2017.07.075 . 28867129 .
7. Chen Y, Popko B . Cholesterol crystals impede nerve repair . . 359 . 6376 . 635–636 . 2018 . 10.1126/science.aar7369 . 29439228 . 2018Sci...359..635C . 3257111 .
8. Cantuti-Castelvetri L, Fitzner D, Bosch-Queralt M, Weil MT, Su M, Sen P, Ruhwedel T, Mitkovski M, Trendelenburg G, Lütjohann D, Möbius W, Simons M . Defective cholesterol clearance limits remyelination in the aged central nervous system . . 359 . 6376 . 684–688 . 2018 . 10.1126/science.aan4183 . 29301957 . 2018Sci...359..684C . 21.11116/0000-0000-2F49-B . free .