Three-hydroxy-3-methylglutaryl coenzyme A synthase (HMGCS) 1 was identified to interact with Gal-7, a pro-apoptotic β-galactoside‒binding protein, by yeast two-hybrid system. Their interaction was confirmed by in vitro β-galactosidase, Biacore, and immunoprecipitation assays. A distinct interactive site of HMGCS1 was found to reside at phenylalanine 26. The expression of HMGCS1 in cultured keratinocytes was upregulated by exogenous Gal-7 and downregulated in LGALS7 small interfering RNA‒transfected cells. HMGCS1-overexpressing cells were found to induce Gal-7 expression, which suggests that Gal-7 and HMGCS1 expressions are both stimulated by positive feedback regulation. The amount of cholesterol, a final biosynthetic product of HMGCS1-involved pathway, was increased in Gal-7‒treated cells and was significantly reduced in LGALS7 small interfering RNA‒transfected cells. The increase of cholesterol level in Gal-7‒treated cells was inhibited by wild-type HMGCS1 peptide but not by phenylalanine 26‒mutated peptide, suggesting that the interaction of Gal-7/HMGCS1 is related to cellular cholesterol level. Foam cells in granulomatous tissues of the specimens from normolipidemic cutaneous xanthoma showed positive reactions with the antibodies for Gal-7 and HMGCS1 as well as for lipid markers. These results are likely to indicate that Gal-7 induction in epidermal keratinocytes causes both apoptotic cell death and HMGCS1-mediated cholesterol accumulation, which will be phagocytized by macrophages. This mechanism may explain the pathogenesis of normolipidemic cutaneous xanthoma.
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