Figure 6

Potential mechanism for enhanced plasma CatD levels during adult NASH.
In adults, under normal conditions, circulating cholesterol-rich lipoproteins are endocytosed and directly distributed to the lysosomes. There, lipoprotein-derived cholesteryl esters are further processed following release into the cytoplasm. Under conditions with high cholesterol-rich lipoprotein levels, which is commonly associated with NASH, Kupffer cells internalize high amounts of lipoproteins, leading to enlarged lysosomes. These large cholesterol-filled lysosomes can potentially disturb the trafficking of lysosomes, which can lead to migration of the lysosome towards the plasma membrane. Hence, enhanced extracellular secretion of CatD into the plasma can occur.