LDLRAP1 (low density lipoprotein receptor adaptor protein 1) is a clathrin-associated sorting protein essential for efficient endocytosis of the LDL receptor in polarized cells such as hepatocytes and lymphocytes 1. The protein functions as an adapter within the clathrin endocytic machinery, facilitating LDL receptor internalization by stabilizing interactions between receptors and coated pit structural components and binding phosphoinositides that regulate clathrin bud assembly 1. LDLRAP1 mutations cause autosomal recessive hypercholesterolemia (ARH), characterized by elevated plasma LDL cholesterol levels and increased atherosclerotic cardiovascular disease risk, though generally less severe and more responsive to therapy than dominant familial hypercholesterolemia 123. ARH patients typically exhibit LDL receptor accumulation at the cell surface with impaired LDL internalization in some cell types 1. Beyond lipid metabolism, LDLRAP1 deletion impacts metabolic homeostasis—LDLRAP1-knockout mice demonstrate increased weight gain, insulin resistance, and dysregulated adipose tissue function, suggesting LDLRAP1 links hypercholesterolemia with obesity and metabolic dysfunction comorbidities 4. Additionally, exogenous plant microRNAs can suppress LDLRAP1 expression, potentially affecting LDL clearance from circulation 5. Early diagnosis and LDL-lowering therapy targeting LDLRAP1-associated hypercholesterolemia are critical for reducing atherosclerotic disease burden.