Using fluorescence microscopy, we have quantified low density lipoprotein (LDL) binding by indirect immunofluorescence and cellular cholesterol with the fluorescent sterol-binding polyene, filipin, in individual cultured human fibroblasts from normal subjects and from patients with heterozygous and homozygous familial hypercholesterolemia. LDL binding by fibroblasts from heterozygous patients was about 40% of that of the normal cells, and cholesterol accumulation upon incubation with LDL was decreased to a similar degree. Most fibroblasts from homozygous patients bound no detectable LDL and only rare cells demonstrated any accumulation of cholesterol after incubation with LDL.

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