Scientists discovered a new type of lipid called N‑acyl‑O‑phosphocholineserine (APCS) that builds up in the blood and tissues of people (and cats) with Niemann‑Pick disease type C1, a rare cholesterol‑storage disorder. They figured out its exact structure, made a lab version, and showed it matches the natural molecule.

Niemann-Pick disease type C1 (NPC1) is a fatal, neurodegenerative, cholesterol storage disorder. With new therapeutics in clinical trials, there is an urgency to improve diagnostics and monitor therapeutic efficacy with biomarkers. In this study, we sought to define the structure of an unknown lipid biomarker for NPC1 with [M + H]⁺ ion at <i>m/z</i> 509.3351, previously designated as lysoSM-509. The structure of <i>N</i>-palmitoyl-<i>O</i>-phosphocholineserine (PPCS) was proposed for the lipid biomarker based on the results from mass spectrometric analyses and chemical derivatizations. As no commercial standard is available, authentic PPCS was chemically synthesized, and the structure was confirmed by comparison of endogenous and synthetic compounds as well as their derivatives using liquid chromatography-tandem mass spectrometry (LC-MS/MS). PPCS is the most abundant species among <i>N</i>-acyl-<i>O</i>-phosphocholineserines (APCS), a class of lipids that have not been previously detected in biological samples. Further analysis demonstrated that all APCS species with acyl groups ranging from C14 to C24 were elevated in NPC1 plasma. PPCS is also elevated in both central and peripheral tissues of the NPC1 cat model. Identification of APCS structures provide an opportunity for broader exploration of the roles of these novel lipids in NPC1 disease pathology and diagnosis.