id: MODULE:intestinal_retinoid_absorption
title: Intestinal absorption of dietary vitamin A — PNLIP/PNLIPRP2/PLB1 retinyl ester hydrolysis, SCARB1/CD36 carotenoid
  uptake, BCO1 central cleavage, retinal reduction, CRBP2 binding, LRAT re-esterification, chylomicron export, ABCA1 retinol
  efflux and ISX feedback
description: >-
  Animals cannot make vitamin A and obtain it from the diet either as preformed retinyl esters of animal
  foods or as provitamin A carotenoids of plants, chiefly beta-carotene. Both forms are absorbed by the
  enterocytes of the proximal small intestine. Dietary retinyl esters must first be hydrolysed: in the
  lumen by pancreatic triglyceride lipase (PNLIP, with its cofactor colipase) and pancreatic lipase-related
  protein 2 (PNLIPRP2), and at the brush border by phospholipase B1 (PLB1). The free retinol released
  enters the enterocyte, largely by diffusion. Carotenoids are taken up across the brush border membrane
  with the help of the class B scavenger receptors SR-BI (SCARB1) and CD36. In the cytosol the
  carotenoid oxygenase BCO1 cleaves beta-carotene at its central double bond into two molecules of
  all-trans-retinal, which is reduced to all-trans-retinol by an NADPH-dependent retinal reductase whose
  identity in human enterocytes is not settled (AKR1B10 and RDH11 are candidates). Retinol from both
  sources is bound by cellular retinol-binding protein 2 (CRBP2, RBP2), an abundant intestine-specific
  carrier, and re-esterified with long-chain fatty acids, mainly by LRAT. The new retinyl esters, together
  with unconverted carotenoids, are packaged into chylomicrons and secreted into the lymph. Some free
  retinol leaves the cell across the basolateral membrane, partly by an ABCA1-dependent route, and reaches
  the portal blood. Carotenoid absorption and cleavage are under negative feedback: retinoic acid induces
  the intestine-specific homeobox transcription factor ISX, which represses transcription of the SCARB1
  and BCO1 genes. Loss of SR-BI impairs beta-carotene absorption in mice, loss of CRBP2 reduces retinol
  uptake and hepatic vitamin A stores, and loss of ISX derepresses SCARB1 and BCO1.
status: DRAFT
scope: CONCRETE
evidence:
- source_id: PW:0000141
  title: retinol metabolic pathway
  statement: >-
    The module boundary follows the RGD Pathway Ontology record and diagram for this term, which despite its
    name describe intestinal absorption of dietary vitamin A. The diagram draws dietary retinyl esters
    hydrolysed to all-trans-retinol (Pnlip, Pnliprp2, Plb1), carotenoids taken up (Scarb1, Cd36) and
    converted to retinal (Bcmo1), retinal reduced to cellular retinol (Akr1b10, NADPH to NADP+), cellular
    retinol associated with Rbp2, re-esterified (Lrat) or released as circulating retinol (Abca1), with
    passive diffusion of retinol drawn as a label. The RGD-curated human gene set is ABCA1, AKR1B10, ALDH1A2,
    BCO1, CD36, LRAT, PLB1, PNLIP, PNLIPRP2, RBP2 and SCARB1. Derived through projects/RGD_PATHWAY_ONTOLOGY
    (pathways/PW_0000141.yaml).
- source_id: file:projects/RGD_PATHWAY_ONTOLOGY/pathways/PW_0000141.yaml
  title: RGD PW:0000141 record text (project snapshot)
  statement: >-
    The RGD record assigns luminal and brush-border hydrolysis of dietary retinyl esters to the two pancreatic
    lipases and phospholipase B1.
  supporting_text: The pancreatic lipases Pnlip and Pnliprp2, known as Ptl and Plrp-2, respectively and the
    phospholipase B1 located in the brush border membrane of absorptive cells, carry out the reaction.
- source_id: file:projects/RGD_PATHWAY_ONTOLOGY/pathways/PW_0000141.yaml
  title: RGD PW:0000141 record text (project snapshot)
  statement: >-
    The RGD record describes the two fates of enterocyte retinol bound to RBP2: LRAT re-esterification and
    ABCA1-mediated efflux.
  supporting_text: In the cell, free retinol is in complex with Rbp2 retinol binding protein and is re-esterified
    to retinyl esters (RE) by Lrat or is released into the circulation via Abca1-mediated efflux
- source_id: file:projects/RGD_PATHWAY_ONTOLOGY/pathways/PW_0000141.yaml
  title: RGD PW:0000141 record text (project snapshot)
  statement: >-
    The RGD record describes ISX feedback on Scarb1 and Bcmo1 in prose, although ISX is not drawn or listed
    among the RGD genes.
  supporting_text: Expression of Isx results in repression of Scarb1 and Bcmo1 genes, providing a negative
    feedback loop between cellular dietary vitamin A metabolites and its uptake and production.
- source_id: GO:0042572
  title: retinol metabolic process
  statement: >-
    The skos:closeMatch GO mapping of PW:0000141 (RGD page GO xref, PW definition xref and lexical match;
    projects/RGD_PATHWAY_ONTOLOGY/data/module_seeds.yaml). It is kept as a module-level concept because the
    pathway produces, binds and esterifies retinol, but it is broader than this module, which covers only its
    intestinal absorption arm; GO:0098856 intestinal lipid absorption is added beside it for that reason.
- source_id: PMID:21718801
  title: Mechanisms involved in the intestinal absorption of dietary vitamin A and provitamin A carotenoids.
  statement: >-
    The review that RGD cites for most of the pathway genes summarises the same sequence of steps: carotenoid
    cleavage and retinal reduction, retinyl ester hydrolysis, re-esterification by LRAT and chylomicron export.
  supporting_text: In the intestinal mucosa β-carotene is converted to retinal by β-C 15,15′ oxygenase 1 (BCO1)
    and the retinal is then reduced to retinol by a retinal reductase
- source_id: PMID:21718801
  title: Mechanisms involved in the intestinal absorption of dietary vitamin A and provitamin A carotenoids.
  statement: Re-esterified retinol leaves the enterocyte in chylomicrons with other neutral lipids and intact carotenoids.
  supporting_text: The resulting retinyl esters are incorporated with other neutral lipid esters (i.e., triacylglycerols
    and cholesteryl esters) and intact carotenoids into chylomicrons and absorbed via the lymphatics
- source_id: Reactome:R-HSA-975634
  title: Retinoid metabolism and transport
  statement: Reactome describes the same enterocyte route for dietary carotenes and retinyl esters.
  supporting_text: Transport from enterocytes to the liver happens via chylomicrons
module:
  id: intestinal_retinoid_absorption
  label: Intestinal absorption of dietary vitamin A
  module_type: METABOLIC_PATHWAY
  concepts:
  - preferred_term: retinol metabolic process
    term:
      id: GO:0042572
      label: retinol metabolic process
    description: >-
      The closeMatch of PW:0000141. Broader than this module, which models the intestinal absorption arm only.
  - preferred_term: intestinal lipid absorption
    term:
      id: GO:0098856
      label: intestinal lipid absorption
    description: >-
      Retinyl esters, retinol and carotenoids are dietary lipids absorbed alongside triacylglycerol and
      cholesterol, using shared lipases, scavenger receptors and chylomicrons.
  context:
    taxa:
    - preferred_term: Homo sapiens
      term:
        id: NCBITaxon:9606
        label: Homo sapiens
    cell_types:
    - preferred_term: enterocyte
      term:
        id: CL:0000584
        label: enterocyte
      description: >-
        The absorptive cell of the small intestine. Luminal hydrolysis acts just outside it, in the gut lumen
        and at its brush border.
  parts:
  - order: 1
    role: hydrolysis of dietary retinyl esters in the gut lumen and at the brush border
    node:
      id: retinyl_ester_hydrolysis
      label: Luminal and brush-border retinyl ester hydrolysis (PNLIP, PNLIPRP2, PLB1)
      module_type: REACTION
      description: >-
        Dietary retinyl esters, mainly retinyl palmitate, cannot be absorbed intact and are hydrolysed to
        all-trans-retinol and fatty acid before uptake. Several lipases share the work, depending on how the
        ester is presented (emulsion droplets, mixed micelles or vesicles) and on age: colipase-dependent
        pancreatic triglyceride lipase (PNLIP) is the main pancreatic retinyl ester hydrolase, pancreatic
        lipase-related protein 2 (PNLIPRP2) hydrolyses micelle-solubilised esters, and phospholipase B1 (PLB1)
        is an intrinsic brush-border enzyme. They are modelled as alternatives in one variant set. The released
        retinol is taken up largely by diffusion, which has no protein participant here.
      evidence:
      - source_id: PMID:21718801
        statement: More than one enzyme probably shares luminal retinyl ester hydrolysis, and a brush-border activity
          has been attributed to phospholipase B.
        supporting_text: Thus, more than one enzyme may be responsible for the complete hydrolysis of retinyl esters
          in the intestinal lumen.
      variant_sets:
      - id: retinyl_ester_hydrolase
        label: Retinyl ester hydrolase
        axis: enzyme and site of action (pancreatic lipases in the lumen versus brush-border phospholipase B1)
        selection: ONE_OR_MORE
        variants:
        - id: pnlip_variant
          label: PNLIP (pancreatic triglyceride lipase, with colipase)
          module_type: REACTION
          annotons:
          - id: pnlip_retinyl_ester_hydrolase
            label: PNLIP all-trans-retinyl-palmitate hydrolase
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: PNLIP
                term:
                  id: UniProtKB:P16233
                  label: Pancreatic triacylglycerol lipase
            function:
              preferred_term: all-trans-retinyl-palmitate hydrolase, all-trans-retinol forming activity
              term:
                id: GO:0047376
                label: all-trans-retinyl-palmitate hydrolase, all-trans-retinol forming activity
              substrates:
              - preferred_term: all-trans-retinyl palmitate
                term:
                  id: CHEBI:17616
                  label: all-trans-retinyl palmitate
              products:
              - preferred_term: all-trans-retinol
                term:
                  id: CHEBI:17336
                  label: all-trans-retinol
              - preferred_term: hexadecanoate
                term:
                  id: CHEBI:7896
                  label: hexadecanoate
            locations:
            - preferred_term: extracellular region
              term:
                id: GO:0005576
                label: extracellular region
            role_description: >-
              Secreted pancreatic lipase that acts on emulsified and micellar retinyl esters and needs colipase
              (CLPS) to do so. GO:0047376 is an experimental GOA row (EXP, PMID:10769148). Its main function
              is triacylglycerol hydrolysis (GO:0004806); retinyl esters are digested by the same enzyme as
              the other dietary neutral lipid esters.
            evidence:
            - source_id: PMID:10769148
              statement: Purified human PTL hydrolyses retinyl esters, and PTL is the major pancreatic retinyl ester
                hydrolase in rodents.
              supporting_text: Finally, purified human PTL exhibited similar enzymatic characteristics for triglyceride
                hydrolysis as well as for retinyl ester hydrolysis, indicating that RE is a substrate for PTL in vivo.
            - source_id: PMID:16497549
              statement: Pancreatic lipase hydrolysis of retinyl palmitate depends on colipase.
              supporting_text: This hydrolysis was abolished when colipase was not added to the medium.
            - source_id: Reactome:R-HSA-975593
              statement: Reactome models PNLIP:CLPS hydrolysis of retinyl palmitate in the lumen.
              supporting_text: Pancreatic lipase catalyses the hydrolysis of RE to all-trans-retinol (atROL) and fatty
                acid which are then both taken up by enterocytic cell membranes
            gocam_associations:
            - model: gomodel:66f5faaa00001204
              activity: gomodel:66f5faaa00001204/66f5faaa00001321
              title: Retinoid Metabolic Process 1 (Mouse)
              description: Mouse Pnlip GO:0050253 retinyl-palmitate esterase activity in the extracellular region.
            - model: gomodel:67086be200002592
              activity: gomodel:67086be200002592/67086be200002614
              title: Retinoid Metabolic Process 3 (Mouse)
              description: Mouse Pnlip GO:0050253 retinyl-palmitate esterase activity in the extracellular region.
        - id: pnliprp2_variant
          label: PNLIPRP2 (pancreatic lipase-related protein 2)
          module_type: REACTION
          annotons:
          - id: pnliprp2_retinyl_ester_hydrolase
            label: PNLIPRP2 retinyl-palmitate esterase
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: PNLIPRP2
                term:
                  id: UniProtKB:P54317
                  label: Pancreatic lipase-related protein 2
            function:
              preferred_term: retinyl-palmitate esterase activity
              term:
                id: GO:0050253
                label: retinyl-palmitate esterase activity
              substrates:
              - preferred_term: all-trans-retinyl palmitate (in mixed micelles)
                term:
                  id: CHEBI:17616
                  label: all-trans-retinyl palmitate
              products:
              - preferred_term: all-trans-retinol
                term:
                  id: CHEBI:17336
                  label: all-trans-retinol
              - preferred_term: hexadecanoate
                term:
                  id: CHEBI:7896
                  label: hexadecanoate
            locations:
            - preferred_term: extracellular region
              term:
                id: GO:0005576
                label: extracellular region
            role_description: >-
              Colipase-independent pancreatic lipase with broad specificity (triacylglycerol, galactolipid and
              phospholipid lipase activities are experimental in human GOA). Retinyl palmitate hydrolysis was shown
              with the purified horse enzyme, only for micelle-solubilised ester and at about one third of the PL
              rate, so GO:0050253 is authored here from that evidence and is not a human experimental GOA row.
              Human PNLIPRP2 is polymorphic and many people carry an inactive allele (the gene is named
              gene/pseudogene by HGNC), which limits its contribution in adults.
            evidence:
            - source_id: PMID:16497549
              statement: PLRP2 hydrolyses retinyl palmitate in mixed micelles but not in emulsions, and PLRP1 does not.
              supporting_text: PLRP2 hydrolyzes RP only when RP is solubilized in mixed micelles
        - id: plb1_variant
          label: PLB1 (brush-border phospholipase B1)
          module_type: REACTION
          annotons:
          - id: plb1_retinyl_ester_hydrolase
            label: PLB1 brush-border retinyl ester hydrolase
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: PLB1
                term:
                  id: UniProtKB:Q6P1J6
                  label: Phospholipase B1, membrane-associated
            function:
              preferred_term: retinyl-palmitate esterase activity
              term:
                id: GO:0050253
                label: retinyl-palmitate esterase activity
              substrates:
              - preferred_term: all-trans-retinyl palmitate
                term:
                  id: CHEBI:17616
                  label: all-trans-retinyl palmitate
              products:
              - preferred_term: all-trans-retinol
                term:
                  id: CHEBI:17336
                  label: all-trans-retinol
              - preferred_term: hexadecanoate
                term:
                  id: CHEBI:7896
                  label: hexadecanoate
            locations:
            - preferred_term: brush border membrane
              term:
                id: GO:0031526
                label: brush border membrane
            role_description: >-
              Intrinsic brush-border membrane phospholipase B of the distal small intestine. The retinyl ester
              hydrolase purified from rat brush border is very probably this enzyme. In human GOA, GO:0050253
              rests on IBA and Reactome TAS; there is no human experimental row.
            evidence:
            - source_id: PMID:8117729
              statement: The rat brush-border retinyl ester hydrolase is immunologically identical to brush-border
                phospholipase B and prefers retinyl palmitate to phosphatidylcholine.
              supporting_text: A polyclonal antiserum against rat brush border phospholipase B reacted with the purified
                retinyl ester hydrolase, strongly suggesting that this enzyme was the same as that previously purified
                and characterized as a calcium-independent brush border phospholipase B
  - order: 2
    role: carotenoid uptake across the brush border membrane
    node:
      id: carotenoid_uptake
      label: Class B scavenger receptor-facilitated carotenoid uptake (SCARB1, CD36)
      module_type: TRANSPORT_STEP
      description: >-
        Beta-carotene and other provitamin A carotenoids are taken up from mixed micelles across the apical
        brush border. Uptake is saturable and facilitated by the class B scavenger receptors SR-BI (SCARB1),
        which predominates in the duodenum and is needed for beta-carotene absorption in mice, and CD36.
        Neither receptor is specific for carotenoids: both also take up cholesterol, phospholipids and fatty
        acids, and GO has no molecular function term for this lipid-uptake activity, so the annotons carry
        the carotenoid transport process without a function term. Unconverted carotenoids pass on to
        chylomicrons; the fraction that is cleaved enters the BCO1 step.
      concepts:
      - preferred_term: carotenoid transport
        term:
          id: GO:0046867
          label: carotenoid transport
      evidence:
      - source_id: PMID:15766282
        statement: SR-BI and CD36 in the brush border membrane facilitate beta-carotene absorption, and SR-BI is
          essential for it in mice on a high-fat diet.
        supporting_text: SR-BI is essential for beta-carotene absorption, at least in mice on a high fat diet.
      variant_sets:
      - id: class_b_scavenger_receptor
        label: Class B scavenger receptor
        axis: receptor paralogue (SR-BI predominant in the duodenum; CD36 more distal)
        selection: ONE_OR_MORE
        variants:
        - id: scarb1_variant
          label: SCARB1 (SR-BI)
          module_type: TRANSPORT_STEP
          annotons:
          - id: scarb1_carotenoid_uptake
            label: SR-BI facilitated carotenoid uptake
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: SCARB1 (SR-BI)
                term:
                  id: UniProtKB:Q8WTV0
                  label: Scavenger receptor class B member 1
            processes:
            - preferred_term: carotenoid transport
              term:
                id: GO:0046867
                label: carotenoid transport
            locations:
            - preferred_term: brush border membrane
              term:
                id: GO:0031526
                label: brush border membrane
            role_description: >-
              High-density lipoprotein receptor (GO:0070506, IDA) that mediates selective lipid uptake. Here it
              facilitates beta-carotene, alpha-carotene and beta-cryptoxanthin uptake into enterocytes but not
              retinol uptake. No function term is asserted (see node description). Its transcription is
              repressed by ISX (part 8).
            evidence:
            - source_id: PMID:17644776
              statement: SR-BI inhibition decreases carotenoid uptake by Caco-2 cells but does not affect retinol
                transport.
              supporting_text: Scavenger receptor class B type I (SR-BI) inhibition did not affect ROL transport but
                decreased carotenoid uptake.
            - source_id: PMID:23427331
              statement: SR-BI and CD36 take part in cellular uptake of provitamin A carotenoids in Caco-2 and HEK cells.
              supporting_text: SR-BI and CD36 are involved in cellular uptake of provitamin A carotenoids
        - id: cd36_variant
          label: CD36
          module_type: TRANSPORT_STEP
          annotons:
          - id: cd36_carotenoid_uptake
            label: CD36 facilitated carotenoid uptake
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: CD36
                term:
                  id: UniProtKB:P16671
                  label: Platelet glycoprotein 4
            processes:
            - preferred_term: carotenoid transport
              term:
                id: GO:0046867
                label: carotenoid transport
            locations:
            - preferred_term: brush border membrane
              term:
                id: GO:0031526
                label: brush border membrane
            role_description: >-
              Multiligand scavenger receptor and long-chain fatty acid transporter (GO:0005324, IMP). Its role
              in carotenoid uptake rests on transfected cells and brush-border vesicles, with genetic association
              of CD36 variants with plasma provitamin A carotenoid levels, and is less established in vivo than
              that of SR-BI. No function term is asserted (see node description).
            evidence:
            - source_id: PMID:15766282
              statement: Transfected SR-BI or CD36 confers on COS-7 cells uptake of dietary lipids including beta-carotene.
              supporting_text: Both scavenger receptors facilitate the uptake of dietary lipids such as beta-carotene,
                free and esterified cholesterol, phospholipids, and fatty acids into COS-7 cells.
            - source_id: PMID:23427331
              statement: Variants in SCARB1 and CD36 associate with plasma provitamin A carotenoid concentrations.
              supporting_text: genetic variations in their encoding genes may modulate plasma concentrations of provitamin
                A carotenoids at a population level
  - order: 3
    role: central cleavage of beta-carotene to retinal
    node:
      id: beta_carotene_cleavage
      label: BCO1 central cleavage of beta-carotene to all-trans-retinal
      module_type: REACTION
      description: >-
        The cytosolic non-heme iron oxygenase BCO1 cleaves all-trans-beta-carotene at the central 15,15'
        double bond to give two molecules of all-trans-retinal, the route by which provitamin A carotenoids
        become vitamin A. The mitochondrial eccentric-cleavage enzyme BCO2, which RGD mentions but does not
        draw, is not modelled. BCO1 transcription is repressed by ISX (part 8).
      concepts:
      - preferred_term: carotene catabolic process
        term:
          id: GO:0016121
          label: carotene catabolic process
      annotons:
      - id: bco1_carotene_dioxygenase
        label: BCO1 beta-carotene 15,15'-dioxygenase
        participant:
          selector_type: GENE_PRODUCT
          gene_product:
            preferred_term: BCO1
            term:
              id: UniProtKB:Q9HAY6
              label: Beta,beta-carotene 15,15'-dioxygenase
        function:
          preferred_term: beta-carotene 15,15'-dioxygenase activity
          term:
            id: GO:0003834
            label: beta-carotene 15,15'-dioxygenase activity
          substrates:
          - preferred_term: all-trans-beta-carotene
            term:
              id: CHEBI:17579
              label: beta-carotene
          - preferred_term: O2
            term:
              id: CHEBI:15379
              label: dioxygen
          products:
          - preferred_term: all-trans-retinal (two molecules)
            term:
              id: CHEBI:17898
              label: all-trans-retinal
        processes:
        - preferred_term: carotene catabolic process
          term:
            id: GO:0016121
            label: carotene catabolic process
        locations:
        - preferred_term: cytosol
          term:
            id: GO:0005829
            label: cytosol
        role_description: >-
          GO:0003834 and GO:0016121 are experimental GOA rows (IDA, PMID:11401432 and PMID:24668807; IMP,
          PMID:17951468). The cytosolic location follows the RGD record and the cited review; there is no
          experimental human cellular component row.
        evidence:
        - source_id: PMID:11401432
          statement: Recombinant human BCO1 has beta,beta-carotene-15,15'-dioxygenase activity and is expressed in intestine.
          supporting_text: Biochemical analysis of baculovirus expressed human BCDO demonstrates the predicted beta,beta-carotene-15,15'-dioxygenase
            activity.
        - source_id: PMID:21718801
          statement: Central cleavage by cytosolic BCO1 is the major route from beta-carotene to retinal.
          supporting_text: The major pathway is the central cleavage catalyzed by a cytosolic enzyme, β-C 15,15′-oxygenase
            1 (BCO1), which cleaves β-C at its central double bond (15,15′) to yield retinal
        gocam_associations:
        - model: gomodel:67086be200002705
          activity: gomodel:67086be200002705/67086be200002803
          title: Retinoid Metabolic Process 4 (Mouse)
          description: >-
            Mouse Bco1 GO:0003834 beta-carotene 15,15'-dioxygenase activity, part of retinoid metabolic process;
            not causally connected to the other activities in the model.
  - order: 4
    role: reduction of retinal to retinol
    node:
      id: retinal_reduction
      label: NADPH-dependent reduction of all-trans-retinal to all-trans-retinol (enzyme unresolved)
      module_type: REACTION
      description: >-
        Retinal made by BCO1 is reduced to retinol, which can then be bound by CRBP2 and esterified. The enzyme
        that does this in human enterocytes has not been identified. Two candidates with experimental
        NADP(H)-dependent all-trans-retinal reductase activity are modelled as variants: the cytosolic
        aldo-keto reductase AKR1B10, the small intestine reductase that RGD draws, and the ER-membrane
        short-chain dehydrogenase/reductase RDH11, which Reactome proposes. Both GO terms are written in the
        oxidative direction; the reaction is reversible and here runs toward retinol.
      evidence:
      - source_id: Reactome:R-HSA-975629
        statement: Reactome states that the enterocyte retinal reductase is not identified and proposes RDH11.
        supporting_text: Although the enzyme catalysing retinal reduction in human enterocytes is not identified,
          the best candidate is retinol dehydrogenase 11 (RDH11, RalR1).
      gocam_associations:
      - model: gomodel:67086be200002705
        activity: gomodel:67086be200002705/67086be200002846
        title: Retinoid Metabolic Process 4 (Mouse)
        description: >-
          The mouse model fills this step with Dhrs3 GO:0052650 all-trans-retinol dehydrogenase (NADP+)
          activity, downstream of Rbp2 and upstream of Lrat. Pinned to the node, not to a variant, because
          DHRS3 is not modelled as an intestinal candidate here.
      variant_sets:
      - id: retinal_reductase
        label: Candidate retinal reductase
        axis: enzyme family and compartment (cytosolic aldo-keto reductase versus ER-membrane SDR)
        selection: ONE_OR_MORE
        variants:
        - id: akr1b10_variant
          label: AKR1B10 (small intestine reductase)
          module_type: REACTION
          annotons:
          - id: akr1b10_retinal_reductase
            label: AKR1B10 all-trans-retinal reductase (NADPH)
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: AKR1B10
                term:
                  id: UniProtKB:O60218
                  label: Aldo-keto reductase family 1 member B10
            function:
              preferred_term: all-trans-retinol dehydrogenase (NADP+) activity
              term:
                id: GO:0052650
                label: all-trans-retinol dehydrogenase (NADP+) activity
              substrates:
              - preferred_term: all-trans-retinal
                term:
                  id: CHEBI:17898
                  label: all-trans-retinal
              - preferred_term: NADPH
                term:
                  id: CHEBI:57783
                  label: NADPH(4-)
              - preferred_term: H+
                term:
                  id: CHEBI:15378
                  label: hydron
              products:
              - preferred_term: all-trans-retinol
                term:
                  id: CHEBI:17336
                  label: all-trans-retinol
              - preferred_term: NADP+
                term:
                  id: CHEBI:58349
                  label: NADP(3-)
            locations:
            - preferred_term: cytosol
              term:
                id: GO:0005829
                label: cytosol
            role_description: >-
              Cytosolic aldo-keto reductase that reduces all-trans-, 9-cis- and 13-cis-retinal efficiently with
              NADPH (GO:0052650, IDA, PMID:12732097; EXP, PMID:18087047). It is broad in specificity and also
              detoxifies other aldehydes such as farnesal and anthracyclines. Its share of retinal reduction in
              the enterocyte in vivo has not been measured.
            evidence:
            - source_id: PMID:12732097
              statement: Human small-intestine aldose reductase (AKR1B10) is an efficient cytosolic NADPH-dependent
                retinal reductase.
              supporting_text: Human AR and HSI AR were very efficient in the reduction of all- trans -, 9- cis - and
                13- cis -retinal
        - id: rdh11_variant
          label: RDH11 (retinol dehydrogenase 11, RalR1)
          module_type: REACTION
          annotons:
          - id: rdh11_retinal_reductase
            label: RDH11 all-trans-retinal reductase (NADPH)
            participant:
              selector_type: GENE_PRODUCT
              gene_product:
                preferred_term: RDH11
                term:
                  id: UniProtKB:Q8TC12
                  label: Retinol dehydrogenase 11
            function:
              preferred_term: all-trans-retinol dehydrogenase (NADP+) activity
              term:
                id: GO:0052650
                label: all-trans-retinol dehydrogenase (NADP+) activity
              substrates:
              - preferred_term: all-trans-retinal
                term:
                  id: CHEBI:17898
                  label: all-trans-retinal
              - preferred_term: NADPH
                term:
                  id: CHEBI:57783
                  label: NADPH(4-)
              - preferred_term: H+
                term:
                  id: CHEBI:15378
                  label: hydron
              products:
              - preferred_term: all-trans-retinol
                term:
                  id: CHEBI:17336
                  label: all-trans-retinol
              - preferred_term: NADP+
                term:
                  id: CHEBI:58349
                  label: NADP(3-)
            locations:
            - preferred_term: endoplasmic reticulum membrane
              term:
                id: GO:0005789
                label: endoplasmic reticulum membrane
            role_description: >-
              ER-membrane SDR with a strong preference for NADP(H) that acts mainly as a retinaldehyde reductase;
              GO:0052650 is the first core function of the completed RDH11 gene review. It sits in the same
              membrane as LRAT, the next step. Not in the RGD gene set; included as the Reactome candidate.
            evidence:
            - source_id: file:human/RDH11/RDH11-ai-review.yaml
              statement: The RDH11 gene review gives GO:0052650 as its core activity, acting mainly in the reductive
                direction.
              supporting_text: acting predominantly in the reductive direction (retinal to retinol)
  - order: 5
    role: binding of cellular retinol and retinal by CRBP2
    node:
      id: crbp2_retinoid_binding
      label: CRBP2 (RBP2) binding of enterocyte retinol
      module_type: TRANSPORT_STEP
      description: >-
        Cellular retinol-binding protein 2 is one of the most abundant soluble proteins of jejunal enterocytes.
        It binds retinol from both the hydrolysis and the carotenoid routes (and retinal), keeps free retinoid
        low and presents retinol to the esterifying enzymes. Loss of CRBP2 in mice halves the saturable component
        of intestinal retinol uptake and lowers hepatic vitamin A stores.
      annotons:
      - id: rbp2_retinol_binding
        label: CRBP2 all-trans-retinol binding
        participant:
          selector_type: GENE_PRODUCT
          gene_product:
            preferred_term: RBP2 (CRBP2)
            term:
              id: UniProtKB:P50120
              label: Retinol-binding protein 2
        function:
          preferred_term: all-trans-retinol binding
          term:
            id: GO:1904768
            label: all-trans-retinol binding
          substrates:
          - preferred_term: all-trans-retinol
            term:
              id: CHEBI:17336
              label: all-trans-retinol
        locations:
        - preferred_term: cytosol
          term:
            id: GO:0005829
            label: cytosol
        role_description: >-
          Intestine-specific FABP-family retinoid chaperone. In human GOA GO:1904768 rests on Reactome TAS and
          retinoid binding (GO:0005501) on TAS; there is no human experimental molecular function row. The mouse
          GO-CAMs model Rbp2 either as a molecular carrier or as an enzyme-substrate adaptor feeding retinol to
          the reductase and LRAT; the binding term is used here as the shared, least interpretive activity.
        evidence:
        - source_id: PMID:12138113
          statement: CRBP2-null mice have impaired saturable retinol uptake and reduced hepatic vitamin A stores.
          supporting_text: The saturable component of intestinal retinol uptake is impaired in CRBP II(-/-) mice.
        - source_id: PMID:21718801
          statement: CRBP2 is thought to present retinoids to enzymes and so direct their metabolism.
          supporting_text: More importantly, it may present retinoids to different enzymes and direct their metabolism
        gocam_associations:
        - model: gomodel:66f5faaa00001204
          activity: gomodel:66f5faaa00001204/66f5faaa00001335
          title: Retinoid Metabolic Process 1 (Mouse)
          description: Mouse Rbp2 GO:0140104 molecular carrier activity in the cytosol.
        - model: gomodel:67086be200002592
          activity: gomodel:67086be200002592/67086be200002616
          title: Retinoid Metabolic Process 3 (Mouse)
          description: Mouse Rbp2 GO:0140104 molecular carrier activity.
        - model: gomodel:67086be200002705
          activity: gomodel:67086be200002705/67086be200002729
          title: Retinoid Metabolic Process 4 (Mouse)
          description: Mouse Rbp2 GO:0140767 enzyme-substrate adaptor activity, upstream of Dhrs3 and Lrat.
  - order: 6
    role: re-esterification of retinol
    node:
      id: retinol_esterification_ref
      label: LRAT esterification of all-trans-retinol
      description: >-
        Included by reference to the LRAT step of the retinoid visual cycle module, which models
        phosphatidylcholine-retinol O-acyltransferase activity on all-trans-retinol. LRAT is the main
        esterifying enzyme in the enterocyte at physiological retinol doses (Lrat-null mice absorb retinol
        mainly as free retinol in chylomicrons); an acyl-CoA-dependent activity, attributed to DGAT1, contributes
        at high doses and is not modelled.
      module_ref: retinoid_visual_cycle#retinol_esterification
  - order: 7
    role: packaging of retinyl esters and carotenoids into chylomicrons and secretion into lymph
    node:
      id: chylomicron_export_ref
      label: Chylomicron assembly and ER export
      description: >-
        Included by reference to the chylomicron assembly module (MTTP, apoB-48, SAR1B). Newly made retinyl
        esters and intact carotenoids travel with triacylglycerol and cholesteryl esters in the chylomicron,
        which is the main exit route for absorbed vitamin A.
      module_ref: chylomicron_assembly_secretion
  - order: 8
    role: transcriptional feedback repression of carotenoid uptake and cleavage by ISX
    optional: true
    node:
      id: isx_feedback
      label: ISX repression of SCARB1 and BCO1 transcription
      module_type: BIOLOGICAL_PROCESS
      description: >-
        Regulatory part, not a step that handles a retinoid. Retinoic acid, acting through the retinoic acid
        receptors, induces the intestine-specific homeobox transcription factor ISX, and ISX represses
        transcription of the SCARB1 and BCO1 genes. When vitamin A is plentiful, carotenoid uptake and
        cleavage are therefore turned down; in vitamin A deficiency ISX falls and both are derepressed. ISX
        acts on the target genes, not on carotenoids or retinoids, so it is modelled as a regulator of the
        uptake and cleavage nodes (NEGATIVELY_REGULATES connections) and not as a participant in them. Optional
        because absorption runs without it; it sets the rate. The RA induction step belongs to the retinoic
        acid receptor signalling module and is not repeated here.
      annotons:
      - id: isx_transcription_repressor
        label: ISX DNA-binding transcriptional repressor of SCARB1 and BCO1
        participant:
          selector_type: GENE_PRODUCT
          gene_product:
            preferred_term: ISX
            term:
              id: UniProtKB:Q2M1V0
              label: Intestine-specific homeobox
        function:
          preferred_term: DNA-binding transcription repressor activity, RNA polymerase II-specific
          term:
            id: GO:0001227
            label: DNA-binding transcription repressor activity, RNA polymerase II-specific
          targets:
          - preferred_term: SCARB1 gene
          - preferred_term: BCO1 gene
        processes:
        - preferred_term: negative regulation of transcription by RNA polymerase II
          term:
            id: GO:0000122
            label: negative regulation of transcription by RNA polymerase II
        locations:
        - preferred_term: nucleus
          term:
            id: GO:0005634
            label: nucleus
        role_description: >-
          Homeodomain transcription factor expressed in intestinal epithelium. Human GOA has only
          sequence-specific double-stranded DNA binding as experimental (IDA, PMID:28473536); GO:0001227 and
          GO:0000122 are IEA by orthology from mouse Isx and are authored here from the mouse knockout and the
          human-cell and mouse studies below. Whether ISX binds the SCARB1 and BCO1 promoters directly is
          stated in the cited work only for BCO1 (abstract-level), so the repression may be partly indirect.
        evidence:
        - source_id: PMID:18093975
          statement: Isx-deficient mice have greatly increased intestinal Bcmo1 and SR-BI expression.
          supporting_text: beta-carotene 15,15'-monooxygenase (EC1.14.99.36 Bcmo1) and the class B type I scavenger
            receptor, which are involved in vitamin A synthesis and carotenoid uptake, respectively, were drastically
            increased in IsxLacZ/LacZ mice.
        - source_id: PMID:20061533
          statement: Retinoic acid induces ISX through RARs, and ISX represses SR-BI and Bcmo1, in mice and human cell lines.
          supporting_text: Retinoic acid via retinoic acid receptors induced expression of the intestinal transcription
            factor ISX. ISX then repressed the expression of SR-B1 and the carotenoid-15,15'-oxygenase Bcmo1.
  - order: 9
    role: basolateral efflux of free retinol
    optional: true
    node:
      id: retinol_efflux
      label: ABCA1-dependent basolateral efflux of free retinol
      module_type: TRANSPORT_STEP
      description: >-
        Part of the absorbed retinol leaves the enterocyte unesterified, outside lipoproteins, and reaches the
        portal circulation; this route matters most when chylomicron secretion is low (fasting, or
        abetalipoproteinemia). In Caco-2 cells the saturable component of retinol efflux is reduced by the ABCA1
        inhibitor glyburide and by ABCA1 knockdown. Optional because it is a secondary exit route, and because
        whether ABCA1 moves retinol itself or acts indirectly through its phospholipid floppase activity and
        nascent HDL formation is not known.
      concepts:
      - preferred_term: retinol transport
        term:
          id: GO:0034633
          label: retinol transport
      evidence:
      - source_id: PMID:17644776
        statement: ABCA1 knockdown reduces retinol efflux but not carotenoid efflux from Caco-2 cells.
        supporting_text: Inhibition of ABCA1 protein expression by small interfering RNAs decreased ROL efflux but
          not carotenoid efflux.
      annotons:
      - id: abca1_lipid_floppase
        label: ABCA1 ATPase-coupled lipid floppase at the basolateral membrane
        participant:
          selector_type: GENE_PRODUCT
          gene_product:
            preferred_term: ABCA1
            term:
              id: UniProtKB:O95477
              label: Phospholipid-transporting ATPase ABCA1
        function:
          preferred_term: ATPase-coupled intramembrane lipid carrier activity
          term:
            id: GO:0140326
            label: ATPase-coupled intramembrane lipid carrier activity
        locations:
        - preferred_term: basolateral plasma membrane
          term:
            id: GO:0016323
            label: basolateral plasma membrane
        role_description: >-
          ABCA1's core activity (core function of the ABCA1 gene review; EXP and IDA rows) is ATP-driven
          phospholipid and cholesterol flopping that loads apoA-I into nascent HDL. Retinol is not shown to be
          a direct ABCA1 substrate, so the annoton carries ABCA1's own activity and no retinol transport process;
          the node concept records the observed outcome. The basolateral location follows the cited Caco-2 work.
        evidence:
        - source_id: file:human/ABCA1/ABCA1-ai-review.yaml
          statement: The ABCA1 review gives ATPase-coupled lipid floppase activity as its first core function.
          supporting_text: ATPase-coupled intramembrane lipid transporter activity
        - source_id: PMID:17644776
          statement: The authors propose that retinol efflux is partly facilitated, probably by basolateral ABCA1.
          supporting_text: ROL efflux is partly facilitated, probably by the basolateral transporter ABCA1
  connections:
  - source: retinyl_ester_hydrolysis
    target: crbp2_retinoid_binding
    connection_type: PROVIDES_INPUT_FOR
    description: Retinol released from dietary esters diffuses into the enterocyte and is bound by CRBP2.
  - source: carotenoid_uptake
    target: beta_carotene_cleavage
    connection_type: PROVIDES_INPUT_FOR
    description: Absorbed beta-carotene is the substrate of cytosolic BCO1.
  - source: beta_carotene_cleavage
    target: retinal_reduction
    connection_type: PROVIDES_INPUT_FOR
    description: All-trans-retinal from central cleavage is reduced to retinol.
  - source: retinal_reduction
    target: crbp2_retinoid_binding
    connection_type: PROVIDES_INPUT_FOR
    description: Carotenoid-derived retinol joins the CRBP2-bound pool.
  - source: crbp2_retinoid_binding
    target: retinol_esterification_ref
    connection_type: PROVIDES_INPUT_FOR
    description: CRBP2-bound retinol is the substrate of LRAT.
  - source: retinol_esterification_ref
    target: chylomicron_export_ref
    connection_type: PROVIDES_INPUT_FOR
    description: Newly made retinyl esters are packaged into chylomicrons.
  - source: carotenoid_uptake
    target: chylomicron_export_ref
    connection_type: PROVIDES_INPUT_FOR
    description: Carotenoids that escape cleavage are secreted intact in chylomicrons.
  - source: crbp2_retinoid_binding
    target: retinol_efflux
    connection_type: PROVIDES_INPUT_FOR
    description: Free retinol not esterified can leave across the basolateral membrane.
  - source: isx_feedback
    target: carotenoid_uptake
    connection_type: NEGATIVELY_REGULATES
    description: ISX represses SCARB1 transcription, lowering carotenoid uptake.
  - source: isx_feedback
    target: beta_carotene_cleavage
    connection_type: NEGATIVELY_REGULATES
    description: ISX represses BCO1 transcription, lowering retinal production from beta-carotene.
knowledge_gaps:
- gap_statement: >-
    The enzyme that reduces BCO1-derived all-trans-retinal to retinol in human enterocytes is not known. AKR1B10
    (cytosolic) and RDH11 (ER membrane) reduce retinal with NADPH in vitro and are expressed in intestine, and a
    mouse GO-CAM uses DHRS3 for the step, but no loss-of-function study has measured the contribution of any of
    them to intestinal retinol formation from beta-carotene.
  gap_kind:
  - BIOLOGY
  status: OPEN
  significance: >-
    Decides whether carotenoid-derived retinal is reduced in the cytosol or at the ER membrane next to LRAT,
    and which gene variants could affect provitamin A conversion efficiency.
- gap_statement: >-
    How ABCA1 supports basolateral efflux of free retinol is unknown: retinol has not been shown to be an ABCA1
    substrate, and the effect could follow from ABCA1-dependent phospholipid efflux and nascent HDL formation.
  gap_kind:
  - BIOLOGY
  status: OPEN
  significance: >-
    Determines whether the non-chylomicron retinol exit route is a transporter step or a consequence of HDL
    biogenesis, and so whether it belongs to this module or to HDL assembly.
notes: >-
  Derived from the RGD Pathway Ontology record and diagram PW:0000141 (retinol metabolic pathway) through the
  RGD_PATHWAY_ONTOLOGY project's diagram->module route; GO mapping GO:0042572 retinol metabolic process
  (skos:closeMatch). Despite its name, the RGD record and diagram describe intestinal absorption of dietary
  vitamin A, which is why this module is named for absorption rather than for retinol metabolism. The 11 RGD-curated
  human genes (RGD source rows in the human gene-pathway file) are ABCA1, AKR1B10, ALDH1A2, BCO1, CD36, LRAT, PLB1,
  PNLIP, PNLIPRP2, RBP2 and SCARB1; the other 72 genes attached to PW:0000141 come from KEGG map00830 and SMPDB and
  cover the whole retinol and retinoic acid network (UGTs, CYP2/3 enzymes, ADHs, RDHs, ER chaperones), so they
  were not used to set the boundary. Modelled as seven required parts and two optional ones: (1) retinyl ester
  hydrolysis, a variant set of PNLIP, PNLIPRP2 and PLB1; (2) carotenoid uptake, a variant set of SCARB1 and CD36;
  (3) BCO1 central cleavage; (4) retinal reduction, a variant set of the candidate reductases AKR1B10 and RDH11;
  (5) CRBP2 binding; (6) LRAT esterification by module_ref to retinoid_visual_cycle#retinol_esterification;
  (7) chylomicron packaging by module_ref to chylomicron_assembly_secretion; (8, optional) ISX feedback; and
  (9, optional) ABCA1-dependent retinol efflux.

  Boundary decisions. (a) ALDH1A2, in the RGD gene set but not drawn, oxidises retinal to retinoic acid; that step
  is modelled in modules/retinoic_acid_metabolism.yaml and is not repeated. That module's notes record PW:0000141
  as considered but not covered and point to a separate absorption module, which this is. (b) LRAT and chylomicron
  assembly are included by module_ref, as retinoic_acid_metabolism does for LRAT, so neither the enzyme nor the
  MTTP/apoB-48/SAR1B machinery is restated. DGAT1 (acyl-CoA:retinol acyltransferase at high retinol doses; a mouse
  GO-CAM gives Dgat1 GO:0050252) is in the KEGG/SMPDB gene list only and is left as context; Lrat-null mice still put some acyl-CoA-derived retinyl ester into chylomicrons (PMID:16115871). (c) Retinal reduction:
  RGD draws AKR1B10, Reactome proposes RDH11 and states that the enterocyte enzyme is not identified, and mouse
  GO-CAM gomodel:67086be200002705 uses Dhrs3. Both AKR1B10 and RDH11 have experimental GO:0052650 and are modelled
  as candidate variants; DHRS3 is mentioned only in the node-level GO-CAM pin because no intestinal evidence for it
  was found. The unknown enzyme is recorded as a knowledge gap; an experiment that would close it is enterocyte-specific
  deletion of each candidate with stable-isotope beta-carotene tracing into lymph retinyl esters. (d) Colipase (CLPS),
  required by PNLIP and modelled as an enzyme activator in the mouse GO-CAMs, is not in the RGD set and is described
  in the PNLIP role rather than modelled as an annoton. Carboxyl ester lipase is excluded because CEL-null mice absorb
  retinyl ester normally (PMID:21718801). (e) Retinol entry into the enterocyte is by diffusion and has no protein
  participant; SCARB1 and CD36 take up carotenoids but not retinol (PMID:23427331, PMID:17644776). (f) ISX is not one
  of the RGD genes; RGD describes its feedback in prose only. ISX acts on the SCARB1 and BCO1 genes, which are
  targets of a transcription factor, not substrates, so it is a regulator: it gets its own optional part whose annoton
  carries its transcription repressor activity, linked to the uptake and cleavage nodes by NEGATIVELY_REGULATES. It is
  not added to those nodes' participants, and no metabolic process term is given to it. The inducing signal (retinoic
  acid acting through RARs) is in modules/retinoic_acid_receptor_signaling.yaml; the module validator therefore warns
  that the feedback loop is cut (isx_feedback has no incoming activating edge here), which is expected. (g) ABCA1
  retinol efflux is optional and its annoton carries ABCA1's own floppase activity, not a retinol term, because
  retinol is not shown to be an ABCA1 substrate. (h) Downstream fates are out of scope: chylomicron remnant uptake by
  liver, hepatic storage and RBP4/STRA6 delivery (in retinoic_acid_metabolism), the visual cycle, and eccentric
  cleavage by BCO2 (described by RGD, not drawn).

  Molecular functions and their support (QuickGO, checked 2026-11-10): PNLIP GO:0047376 (EXP, PMID:10769148);
  BCO1 GO:0003834 (IDA, PMID:11401432, PMID:24668807; IMP, PMID:17951468); AKR1B10 GO:0052650 (IDA, PMID:12732097;
  EXP, PMID:18087047); RDH11 GO:0052650 (core function of the completed RDH11 review); ABCA1 GO:0140326 (IDA and EXP;
  core function of the ABCA1 review). Authored without experimental human GOA support: PNLIPRP2 GO:0050253 (from the
  horse enzyme, PMID:16497549; human experimental rows are triacylglycerol, galactolipid and phospholipid lipase);
  PLB1 GO:0050253 (IBA and Reactome TAS; rat purification PMID:8117729); RBP2 GO:1904768 (Reactome TAS); ISX
  GO:0001227 and GO:0000122 (IEA by orthology; human experimental row is only sequence-specific DNA binding).
  SCARB1 and CD36 carry no function term: their facilitated lipid uptake has no matching GO molecular function, and
  their experimental terms (HDL particle receptor, fatty acid transporter, scavenger receptor) describe other roles.
  The process GO:0046867 carotenoid transport on SCARB1 and CD36 is not in their GOA; it is asserted from the mouse
  knockout and cell studies cited. Comparator check for processes: GO:0016121 is given only to BCO1, which does the
  chemistry; no carotenoid or retinoid process is given to ISX or ABCA1.

  GO-CAM: gocams/index.tsv (checked 2026-11-10) has no human production model for this pathway. The seed's best_gocam
  lead (gomodel:6197061700002397, CD36 fatty acid transport) is unrelated and is not linked. Mouse models are linked at
  activity level: Retinoid Metabolic Process 1 (gomodel:66f5faaa00001204; Pnlip, Rbp2), 3 (gomodel:67086be200002592;
  Pnlip, Rbp2) and 4 (gomodel:67086be200002705; Bco1, Rbp2, and Dhrs3 at the retinal reduction node). Their Lrat
  activities belong to the referenced visual-cycle node and their chylomicron retinoid-binding activities to the
  referenced chylomicron module, so they are not pinned here; Lpl and Ldlr act after secretion and are out of scope.
  Possible upstream issue: in gomodel:67086be200002705 the Bco1 activity is not causally connected to the retinal
  reduction or esterification activities, so the carotenoid branch is disconnected from the rest of that model.
  Gene reviews exist for LRAT, ABCA1 and RDH11; PNLIP, PNLIPRP2, PLB1, SCARB1, CD36, BCO1, AKR1B10, RBP2 and ISX have
  none. PANTHER family ids and PTNs are deliberately not asserted. Most cited publications are abstract-only in the
  cache; PMID:21718801 has full text.
