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Acyl-coenzyme A:cholesterol O-acyltransferase 1 (ACAT1) is an integral membrane enzyme found in the mitochondria and endoplasmic reticulum of cells. It belongs to the membrane-bound O-acyltransferase (MBOAT) family and catalyzes the conversion of free cholesterol and long-chain fatty acyl-CoA into cholesteryl esters for storage or transport. ACAT1 also catalyzes the reversible formation of acetoacetyl-CoA from two molecules of acetyl-CoA during ketogenesis and ketolysis. Mutations in the ACAT1 gene cause beta-ketothiolase deficiency. ACAT1 is considered a drug target for diseases such as atherosclerosis, Alzheimer’s disease and certain cancers.
Inhibition of cholesterol esterification
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