Effect of Ocular Dominance on Ocular Blood Flow Parameters.

PURPOSE: In binocular vision, there is a dominant eye and a nondominant eye, a phenomenon termed ocular dominance. This study determined the differences and associations of the ocular blood flow parameters between dominant and nondominant eyes in healthy Japanese subjects. METHODS: This cross-sectional study included 128 eyes of 64 subjects (13 male and 51 female) aged ≥ 20 years. The ocular blood flow parameters were assessed using laser speckle flowgraphy (LSFG), and software was used to calculate the mean blur rate (MBR), which reflects the blood flow velocity. RESULTS: There were no significant differences in axial length (AL), spherical equivalent (SE), intraocular pressure (IOP), uncorrected visual acuity (UCVA), best-corrected visual acuity (BCVA), or ocular blood flow parameters between the dominant and nondominant eyes. The ocular blood flow parameters of the dominant eye were significantly and positively correlated with those of the nondominant eye (all P < 0.001). CONCLUSIONS: No significant differences in ocular blood flow parameters exist between the dominant and nondominant eyes in healthy subjects. The ocular blood flow parameters in the dominant eye are associated with those in the nondominant eye.

Plant-Derived Lactobacillus paracasei IJH-SONE68 Improves Chronic Allergy Status: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial.

We have recently demonstrated that the exopolysaccharides (EPSs) produced by a plant-derived lactic acid bacterium, Lactobacillus paracasei IJH-SONE68, prevent and ameliorate allergic reaction on contact in dermatitis model mice. In the present study, we conducted a clinical trial using a capsule containing spray-dried powder from pineapple juice broth fermented with the LAB strain as an experimental diet. The clinical trial was conducted as a double-blind and placebo-controlled randomized comparative study from May 2019 to July 2021. Males and females between the ages of 21 and 70 who experience chronic allergies participated in the study. Sixty subjects were instructed to orally take a capsule containing the IJH-SONE68 powder or placebo, every day for 12 weeks. After the clinical trial was over, the scores based on subjects' self-assessment of allergic status were significantly improved in the intervention group, as compared with the placebo group. Some serum biochemicals associated with inflammation response were also significantly improved by intake of the experimental diet. In conclusion, the IJH-SONE68-derived EPS improves chronic allergy status in humans and is expected to decrease their inconvenience.

Reduction of fatigue and anger-hostility by the oral administration of 5-aminolevulinic acid phosphate: a randomized, double-blind, placebo-controlled, parallel study.

Although large populations feel fatigue, the standardized medicinal therapy is currently absent. In this study, we determined whether 5-aminolevulinic acid (5-ALA) supplementation alleviates the feeling of fatigue in healthy subjects who feel chronic physical tiredness. Males and females between ages of 20 and 64 who felt physical fatigue on a daily basis, with a visual analogue scale (VAS) for fatigue ≥ 40 mm, a T-score of Fatigue-Inertia in the Profile of Mood States-Second Edition-Adult (POMS2-A) ≥ 50, and a T-score of Vigor-Activity in POMS2-A ≤ 60 were recruited. Seventy eligible participants were randomly assigned to either a 5-ALA or a placebo group. During the 8 weeks of consumption, the subjects completed VAS questionnaires for fatigue and POMS2-A at 4-week intervals. The VAS values for overall feeling of fatigue and feeling of work-related fatigue, and the Anger-Hostility subscale of POMS2-A were decreased by 5-ALA with significant time × group interaction effects (p = 0.040, 0.020, and 0.045, respectively). Besides, the 5-ALA group showed significant differences in Fatigue-Inertia, Depression-Dejection and Total Mood Disturbance scores, when compared between pre- and post-intervention, while the placebo group did not. In conclusion, the oral administration of 5-ALA improves fatigue and negative mood in subjects who constantly feel physical fatigue.This clinical trial was registered with University hospital Medical Information Network Clinical Trials Registry (UMIN-CTR) as UMIN000031528 on 2/3/2018.

Interleukin-8 Release Inhibitors Generated by Fermentation of Artemisia princeps Pampanini Herb Extract With Lactobacillus plantarum SN13T.

Some glycosides, which are detected in water extracts from medicinal plants, have been reported to be degraded into their aglycones by incubating with some microorganisms producing ß-glucosidase. We have shown that a plant-derived Lactobacillus plantarum SN13T harbors 11 open reading frames (ORFs) encoding the ß-glucosidase enzyme and can grow vigorously in several herbal water extracts. In this study, we observed that the water extract from Artemisia princeps Pampanini (AP) fermented with the SN13T strain strongly inhibited the release of interleukin (IL)-8 from the HuH-7 cells, when compared to that without fermentation. Furthermore, we demonstrated that the SN13T strain produced at least two bioactive compounds from some compounds contained in AP extract. In addition, we determined that the two compounds were catechol and seco-tanapartholide C, which dose-dependently inhibited the release of IL-8. Because some sesquiterpene lactones are useful in pharmaceuticals, seco-tanapartholide C may be useful as an anti-inflammatory agent. This study suggests that the fermentation of medicinal herbs with Lb. plantarum SN13T is a significant technique to obtain bioactive compounds having therapeutic potential.

Improvement of Alcohol-Poisoning Symptoms in Mice by the Oral Administration of Live Lactobacillus plantarum SN13T Cells.

A clinical study carried out previously by our group has demonstrated that yogurt manufactured with a plant-derived lactic acid bacterium, Lactobacillus plantarum SN13T, significantly reduces the γ-glutamyl transpeptidase (γ-GTP) level as a liver-function parameter. In the present study, we show that with the oral administration of live SN13T cells, alcohol-poisoning symptoms in mice are improved, and the condition does not become fatal. However, prior to the simultaneous administration with ethanol, when the cells were heat-killed or sonicated, the improvement was not observed, and almost all of the mice died. In addition, the dysbiosis of the intestinal microbiota observed in the mice administered with ethanol was restored by simultaneous administration with live SN13T cells. Furthermore, by analyzing the metabolites detected in contents from the mouse cecum, it was demonstrated that the increase in nonvolatile putrefactive amines observed in the ethanol-administration group was reduced by simultaneous administration with live SN13T cells. Judging from these results, the lactic acid bacterial cells capable of reaching the living bowels prevent ethanol-induced poisoning and restore the intestinal microbiota.

Quantifying Parkinson's disease finger-tapping severity by extracting and synthesizing finger motion properties.

We propose a novel index of Parkinson's disease (PD) finger-tapping severity, called "PDFTsi," for quantifying the severity of symptoms related to the finger tapping of PD patients with high accuracy. To validate the efficacy of PDFTsi, the finger-tapping movements of normal controls and PD patients were measured by using magnetic sensors, and 21 characteristics were extracted from the finger-tapping waveforms. To distinguish motor deterioration due to PD from that due to aging, the aging effect on finger tapping was removed from these characteristics. Principal component analysis (PCA) was applied to the age-normalized characteristics, and principal components that represented the motion properties of finger tapping were calculated. Multiple linear regression (MLR) with stepwise variable selection was applied to the principal components, and PDFTsi was calculated. The calculated PDFTsi indicates that PDFTsi has a high estimation ability, namely a mean square error of 0.45. The estimation ability of PDFTsi is higher than that of the alternative method, MLR with stepwise regression selection without PCA, namely a mean square error of 1.30. This result suggests that PDFTsi can quantify PD finger-tapping severity accurately. Furthermore, the result of interpreting a model for calculating PDFTsi indicated that motion wideness and rhythm disorder are important for estimating PD finger-tapping severity.

Characterization and Mutational Analysis of a Two-Polypeptide Bacteriocin Produced by Citrus Iyo-Derived Lactobacillus brevis 174A.

In the present study, we isolated a lactic acid bacterium (LAB) from a citrus iyo fruit and identified it as Lactobacillus brevis. This plant-derived LAB strain, designated 174A, produces bacteriocin consisting of two polypeptides designated brevicin 174A-ß and 174A-γ. Although each polypeptide itself displays antibacterial activity, the ability is enhanced 100 fold by mixing both polypeptides at a 1 : 1 ratio. Significantly, brevicin 174A inhibits even the growth of several pathogenic bacteria that are more resistant to a lantibiotic bacteriocin, nisin A, which is commonly utilized as a preservative added to foodstuffs. Structural analysis of the 174A bacteriocin using a program that predicts secondary structure suggests that both component polypeptides have a positively charged N-terminal region, as well as two cysteine residues in both the N- and C-terminals. Judging from a mutational analysis of the antibacterial polypeptides, these unique amino acid sequences of 174A-ß might be important for the expression of the synergistic activity that occurs in the presence of the two polypeptides combined.

An alternative allosteric regulation mechanism of an acidophilic l-lactate dehydrogenase from Enterococcus mundtii 15-1A.

A plant-derived Enterococcus mundtii 15-1A, that has been previously isolated from Brassica rapa L. subsp. nipposinica (L.H. Bailey) Hanelt var. linearifolia by our group, possesses two kinds of l-lactate dehydrogenase (l-LDH): LDH-1 and LDH-2. LDH-1 was activated under low concentration of fluctose-1,6-bisphosphate (FBP) at both pH 5.5 and 7.5. Although LDH-2 was also activated under the low concentration of FBP at pH 5.5, a high concentration of FBP is necessary to activate it at pH 7.5. The present study shows the crystal structures of the acidophilic LDH-2 in a complex with and without FBP and NADH. Although the tertiary structure of the ligands-bound LDH-2 is similar to that of the active form of other bacterial l-LDHs, the structure without the ligands is different from that of any other previously determined l-LDHs. Major structural alterations between the two structures of LDH-2 were observed at two regions in one subunit. At the N-terminal parts of the two regions, the ligands-bound form takes an α-helical structure, while the form without ligands displays more disordered and extended structures. A vacuum-ultraviolet circular dichroism analysis showed that the α-helix content of LDH-2 in solution is approximately 30% at pH 7.5, which is close to that in the crystal structure of the form without ligands. A D241N mutant of LDH-2, which was created by us to easily form an α-helix at one of the two parts, exhibited catalytic activity even in the absence of FBP at both pH 5.5 and 7.5.

Crystallographic and mutational analyses of tannase from Lactobacillus plantarum.

Tannin acylhydrolase (EC 3.1.1.20) referred commonly as tannase catalyzes the hydrolysis of the galloyl ester bond of tannins to release gallic acid. Although the enzyme is useful for various industries, the tertiary structure is not yet determined. In this study, we determined the crystal structure of tannase produced by Lactobacillus plantarum. The tannase structure belongs to a member of α/ß-hydrolase superfamily with an additional "lid" domain. A glycerol molecule derived from cryoprotectant solution was accommodated into the tannase active site. The binding manner of glycerol to tannase seems to be similar to that of the galloyl moiety in the substrate.

5-aminolevulinic acid, a precursor of heme, reduces both fasting and postprandial glucose levels in mildly hyperglycemic subjects.

OBJECTIVE: The aim of this study was to evaluate the combined effects of 5-aminolevulinic acid phosphate (ALA-P) and iron on the glycemic index in mildly hyperglycemic adults. METHODS: This double-blind, randomized placebo-controlled trial comprised 212 subjects (ages 35-70 y, fasting plasma glucose 105-125 mg/dL or hemoglobin (Hb)A1c 6.1%-7.1%). These participants were randomly assigned to four groups receiving either one of three doses of ALA-P and iron as sodium ferrous citrate (5 mg and 0.6 mg, 5 mg and 1.8 mg, or 15 mg and 1.8 mg, respectively) or a placebo, administered orally once a day over a 12-wk period. RESULTS: Fifteen mg ALA-P plus 1.8 mg iron decreased the fasting plasma glucose level (2.32 mg/dL, 95% confidence interval [CI], 0.24-4.42, P = 0.029), serum glycoalbumin (0.22%, 95% CI, 0.02-0.42; P = 0.031), and 2h-oral glucose tolerance test levels (14.2 mg/dL, 95% CI, 1.8-26.6; P = 0.025) more than the placebo. However, the levels of HbA1c, fasting insulin, serum 1,5-anhydro-d-glucitol, and Homeostasis Model of Assessment-Insulin Resistance showed no appreciable changes. The participant numbers with impaired glucose tolerance and impaired fasting glucose decreased in the highest dosage group of ALA-P plus iron compared with the placebo group. CONCLUSION: An oral intake of ALA would be a novel approach to prevent type 2 diabetes mellitus.

The obesity and fatty liver are reduced by plant-derived Pediococcus pentosaceus LP28 in high fat diet-induced obese mice.

We evaluated the effect of an oral administration of a plant-derived lactic acid bacterium, Pediococcus pentosaceus LP28 (LP28), on metabolic syndrome by using high fat diet-induced obese mice. The obese mice were divided into 2 groups and fed either a high fat or regular diet for 8 weeks. Each group was further divided into 3 groups, which took LP28, another plant-derived Lactobacillus plantarum SN13T (SN13T) or no lactic acid bacteria (LAB). The lean control mice were fed a regular diet without inducing obesity prior to the experiment. LP28 reduced body weight gain and liver lipid contents (triglyceride and cholesterol), in mice fed a high fat diet for 8 weeks (40%, 54%, and 70% less than those of the control group without LAB, and P = 0.018, P<0.001, and P = 0.021, respectively), whereas SN13T and the heat treated LP28 at 121°C for 15 min were ineffective. Abdominal visceral fat in the high fat diet mice fed with LP28 was also lower than that without LAB by 44%, although it was not significant but borderline (P = 0.076). The sizes of the adipocytes and the lipid droplets in the livers were obviously decreased. A real-time PCR analyses showed that lipid metabolism-related genes, such as CD36 (P = 0.013), SCD1 encoding stearoyl-CoA desaturase 1 (not significant but borderline, P = 0.066), and PPARγ encoding peroxisome proliferator-activated receptor gamma (P = 0.039), were down-regulated by taking LP28 continuously, when compared with those of the control group. In conclusion, LP28 may be a useful LAB strain for the prevention and reduction of the metabolic syndrome.

Reduction of serum lipids by the intake of the extract of garlic fermented with Monascus pilosus: a randomized, double-blind, placebo-controlled clinical trial.

BACKGROUND & AIMS: A dietary supplement containing garlic fermented with Monascus pilosus (MGFE) may be useful to decrease the lipid concentrations in serum without serious adverse effects. The aim of the study was to assess whether MGFE decreases serum lipid contents in volunteers with mild hyperlipidemia in a randomized, double-blind, placebo-controlled, parallel-group trial. METHODS: Healthy subjects (n = 55) with serum triglyceride concentrations of 120-200mg/dL were randomly assigned to take either MGFE or placebo capsules for 12 wk. RESULTS: A borderline, but not significant effect, to decrease triglyceride concentrations in serum (approximately 15% reduction at maximum, P = 0.062, in time × treatment interaction effect) was observed by the MGFE intake for 12 wk. The decreased reading exhibited a significant difference at wk-8 between the MGFE and placebo groups (unpaired t test, P = 0.007). The total cholesterol (P = 0.003) and LDL cholesterol (P = 0.001) contents in the serum and the LDL/HDL ratio (P < 0.001) were significant in time × treatment interaction effects by the MGFE intake. However, no alteration in the body fat percentage and abdominal circumference was observed. CONCLUSIONS: The intake of MGFE decreased triglyceride and cholesterol in serum with no appreciable adverse effects in normal to mildly hyperlipidemic individuals, suggesting that it may be effective to improve and prevent the metabolic syndrome. This clinical trial was registered with Clinicaltrials.gov as NCT00938249.

A molecular mechanism for copper transportation to tyrosinase that is assisted by a metallochaperone, caddie protein.

The Cu(II)-soaked crystal structure of tyrosinase that is present in a complex with a protein, designated "caddie," which we previously determined, possesses two copper ions at its catalytic center. We had identified two copper-binding sites in the caddie protein and speculated that copper bound to caddie may be transported to the tyrosinase catalytic center. In our present study, at a 1.16-1.58 Å resolution, we determined the crystal structures of tyrosinase complexed with caddie prepared by altering the soaking time of the copper ion and the structures of tyrosinase complexed with different caddie mutants that display little or no capacity to activate tyrosinase. Based on these structures, we propose a molecular mechanism by which two copper ions are transported to the tyrosinase catalytic center with the assistance of caddie acting as a metallochaperone.

Establishment of an in vitro Peyer's patch cell culture system correlative to in vivo study using intestine and screening of lactic acid bacteria enhancing intestinal immunity.

Some lactic acid bacteria (LAB) are known as representative of probiotics. To screen LAB effective to enhance intestinal immunity, in the present study, we developed an accurate and convenient in vitro evaluation system using Peyer's patch cells (PP-cells) isolated from the mice intestine. We observed that the amount of immunoglobulin A (IgA) produced by PP-cells co-cultured with LAB was well correlative to that in PP-cells, intestine and feces isolated from live mice after oral administration of LAB [correlation coefficient (r)=0.888, 0.883, and 0.920, respectively]. In addition, using this in vitro system, we suggest that the IgA level of PP-cells co-culturing with plant-derived LAB might be more enhanced than with animal-derived LAB.

Improvement of constipation and liver function by plant-derived lactic acid bacteria: a double-blind, randomized trial.

OBJECTIVE: Lactic acid bacteria (LAB) contribute to human health; however, the probiotic properties vary among strains classified into the same species. The primary objective of this study was to evaluate the effects of yogurts made by different types of LAB on the gastrointestinal system. The yogurts were also evaluated by measuring serum lipid contents and liver functional indicators as a secondary objective. METHODS: Healthy human adults (n = 68) with some complaints with regard to intestinal health, including constipation and diarrhea, were randomly assigned to receive one of three types of yogurt in a double-blind manner: type A, a yogurt made by plant-derived LAB (mainly Lactobacillus [Lb.] plantarum SN35N); type B, a yogurt made by plant-derived LAB (mainly Lb. plantarum SN13T); and type C, a yogurt made by animal-derived LAB (mainly Lactococcus lactis A6 and Streptococcus thermophilus 510) as a control. The subjects consumed 100 g of yogurt daily for 6 wk. Data were collected from clinical visits at 2-wk intervals and by diaries used to record defecation and health conditions. RESULTS: Drastic and constant increments of defecation frequency in subjects with constipation were observed with type A and B yogurts but not with type C yogurt. Type B and C yogurts resulted in decreases in total and low-density lipoprotein cholesterol. The serum concentrations of liver functional parameters were improved by the type B yogurt (12-25% reduction). CONCLUSION: The present study suggests that Lb. plantarum SN13T exhibits a superior probiotic effect on constipation in addition to improving the serum lipid contents and liver function.

Polymeric osteopontin employs integrin alpha9beta1 as a receptor and attracts neutrophils by presenting a de novo binding site.

Osteopontin (OPN) is a cytokine and ligand for multiple members of the integrin family. OPN undergoes the in vivo polymerization catalyzed by cross-linking enzyme transglutaminase 2, which consequently increases the bioactivity through enhanced interaction with integrins. The integrin alpha9beta1, highly expressed on neutrophils, binds to the sequence SVVYGLR only after intact OPN is cleaved by thrombin. The SVVYGLR sequence appears to be cryptic in intact OPN because alpha9beta1 does not recognize intact OPN. Because transglutaminase 2-catalyzed polymers change their physical and chemical properties, we hypothesized that the SVVYGLR site might also be exposed on polymeric OPN. As expected, alpha9beta1 turned into a receptor for polymeric OPN, a result obtained by cell adhesion and migration assays with alpha9-transfected cells and by detection of direct binding of recombinant soluble alpha9beta1 with colorimetry and surface plasmon resonance analysis. Because the N-terminal fragment of thrombin-cleaved OPN, a ligand for alpha9beta1, has been reported to attract neutrophils, we next examined migration of neutrophils to polymeric OPN using time-lapse microscopy. Polymeric OPN showed potent neutrophil chemotactic activity, which was clearly inhibited by anti-alpha9beta1 antibody. Unexpectedly, mutagenesis studies showed that alpha9beta1 bound to polymeric OPN independently of the SVVYGLR sequence, and further, SVVYGLR sequence of polymeric OPN was cryptic because SVVYGLR-specific antibody did not recognize polymeric OPN. These results demonstrate that polymerization of OPN generates a novel alpha9beta1-binding site and that the interaction of this site with the alpha9beta1 integrin is critical to the neutrophil chemotaxis induced by polymeric OPN.

Enhanced biological activity of polymeric osteopontin.

Osteopontin is a multifunctional glycoprotein with roles in immunomodulation, inflammatory response, tissue mineralization, and tissue remodeling, which are mediated primarily through integrins. Transglutaminase 2 selectively cross-links proteins by isopeptide bonding. Osteopontin is one of the substrates of this enzyme and undergoes polymerization; however, the biological meaning of this polymerization remains unknown. Using recombinant osteopontin polymerized with purified transglutaminase 2, we examined cell adhesion, spreading, focal contact formation, and migration of SW480 or HUVE cells. All of these cellular behaviors were dramatically enhanced with polymeric osteopontin. These enhancements of cellular functions imply that polymerization might modulate physiological and pathological functions of osteopontin.

The integrin alpha5beta1 regulates chondrocyte hypertrophic differentiation induced by GTP-bound transglutaminase 2.

Soluble GTP-bound transglutaminase 2 (TG2) induces hypertrophic differentiation in chondrocyte cultures in a beta1 integrin-dependent fashion. beta1 integrin subfamily consists of 12 heterodimers with 12 different alpha subunits and a beta1 subunit. To identify the specific integrin heterodimer(s) responsible for this process, we specifically blocked individual beta1 integrins on the CH-8 immortalized human chondrocytes during hypertrophic differentiation. Blockade of alpha5beta1 inhibited matrix metalloproteinase 13 (MMP-13), type X collagen expression, alkaline phosphatase activity and matrix calcification by 30-50% associated with weak effects of anti-alpha3beta1 and -alpha4beta1. Anti-alpha1beta1, -alpha2beta1 and -alpha6beta1 had no effect. To examine whether the dominant effect of integrin alpha5beta1 was due to a direct interaction with TG2, we incubated the chondrocytic cells on plates coated with GTP-bound TG2. The immobilized GTP-bound TG2 induced hypertrophic differentiation to the same extent as the soluble GTP-bound TG2, which was also inhibited by anti-alpha5beta1. CH-8 cells grown on plates coated with GTP-bound TG2 demonstrated adherence associated with focal adhesion kinase phosphorylation. These properties were inhibited by anti-alpha5beta1. Furthermore, engagement of alpha5beta1 on CH-8 cells via anti-alpha5beta1 antibody did, in fact, induce differentiation. Although CH-8 cells adhered to GTP-free TG2 via integrin alpha5beta1, the cells failed to undergo hypertrophic differentiation. Thus, integrin alpha5beta1 is critical for the chondrocyte hypertrophic differentiation induced by GTP-bound TG2, and this induction is ligand dependent.

Genotypes and haplotypes of CCR2 and CCR3 genes in Japanese cedar pollinosis.

Whole genome scan analyses have revealed that the chromosomal region 3p21.3, which contains a gene cluster of the CC chemokine receptor, is possibly critical for the pathogenesis of allergic inflammation. Japanese cedar pollinosis is mediated by a type I allergy and induces seasonal rhinitis and conjunctivitis in humans as the most common form of hay fever in spring in Japan, although the candidate genes for cedar pollinosis remain to be elucidated. We sequenced CCR1, CCR2, CCR3, CCR5, and CCXCR1 using the PCR restriction fragment length polymorphism method in subjects with cedar pollinosis and controls. We found 8 polymorphisms of A111G, Arg127Cys and Arg252Gln in CCXCR1, T885C in CCR1, Val64Ile and T780C in CCR2, T51C in CCR3 and Arg223Gln in CCR5. The transmission disequilibrium test using 60 children with pollinosis and their parents and an association study using unrelated adult subjects (151 patients and 157 controls) showed a significant association of 64Ile in CCR2 and 51C in CCR3 with cedar pollinosis. The frequency of haplotype 64Ile/780C/51C in pollinosis was significantly higher than in controls. Our results suggest that CCR2 and CCR3 genes are candidate genes for Japanese cedar pollinosis.

[Hyperlipidemia: complex pathophysiology caused by multiple genetic and environmental factors--in considering the approaches to preventive medicine].

In Japan, over the last 40 years, the change in lifestyle, particularly the westernization of the diet, has led to increased frequency of "lifestyle-related disorders" such as, hyperlipidemia, diabetes mellitus, and atherosclerosis. Consequently, the morbidity and mortality due to coronary heart disease have increased, and the prevention of this disorder is now one of the major concerns when considering the quality of life of individuals and the public health policy. Hyperlipidemia, particularly hypercholesterolemia, is one of the major risk factors of atherosclerosis. Therefore, the clarification of the mechanisms of the development of hyperlipidemia is important in the consideration of the prevention and management of atherosclerotic disorders. Genetic and epidemiological studies have provided compelling evidence that genetic factors, environmental influences and the interaction between them all contribute to the development of this complex disorder. Various unexpected mechanisms of the development of hyperlipidemia have been elucidated by analyzing some hereditary disorders. Furthermore, the cloning of the genes involved in the maintenance of cholesterol and/or lipid homeostasis has made it possible to investigate the molecular mechanisms of the development of hyperlipidemia in detail. Elucidation of the genetic and environmental factors and detailed understanding of the molecular pathophysiology of hyperlipidemia are essential in the pursuit of evidence-based preventive medicine and health policy.