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HDL therapy for the treatment of cardiovascular diseases
Cinzia Parolini1, Marta Marchesi, Giulia Chiesa
1Department of Pharmacological Sciences, University of Milano, 20133 Milano, Italy.
Insights
High-density lipoprotein (HDL) therapy shows promise for cardiovascular disease by improving vascular health. HDL therapy effectively reduces atherosclerosis in both animal models and humans, offering a new therapeutic avenue.
Area of Science:
- Cardiovascular Medicine
- Pharmacology
- Biochemistry
Background:
- High-density lipoprotein (HDL) levels are a significant independent risk factor for cardiovascular diseases.
- HDL possesses atheroprotective properties, including reverse cholesterol transport, antioxidant, anti-inflammatory, antithrombotic, and vasodilatory effects.
- HDL-cholesterol (HDL-C) raising interventions have demonstrated reduced atherosclerosis in animal models.
Purpose of the Study:
- To provide an overview and update on therapeutic applications of synthetic HDL.
- To evaluate the efficacy of HDL therapy in cardiovascular disease models and clinical trials.
- To explore the potential of HDL/apolipoprotein A-I (apoA-I) enhancement for cardiovascular disease treatment.
Main Methods:
- Review of studies involving synthetic HDL tested in animal models.
- Analysis of clinical trial data for HDL-based therapies.
- Examination of in vitro and in vivo experiments elucidating HDL's atheroprotective mechanisms.
Main Results:
- HDL therapy has proven effective in promoting atherosclerosis regression in experimental models and humans.
- Over-expression of apolipoprotein A-I (apoA-I) reduces atherosclerosis extent in animal models.
- Therapeutic applications beyond atherosclerosis regression are currently limited to animal models.
Conclusions:
- HDL therapy represents an emerging strategy to supplement current cardiovascular treatments.
- The multifaceted atheroprotective effects of HDL support its therapeutic potential.
- Further research is warranted for HDL therapy applications in broader cardiovascular diseases.
Abstract:
High-density lipoprotein (HDL) therapy is an emerging area of therapeutic development in the cardiovascular field, aimed at supplementing and improving the vascular benefit exerted by current treatments. Several studies have clearly established that HDL-cholesterol (HDL-C) levels are a potent and independent epidemiologic risk factor for cardiovascular diseases; moreover, studies in animal models have established that HDL-C raising interventions, such as over-expression of apolipoprotein A-I (apoA-I), the major HDL protein component, reduce the extent of atherosclerosis. In vitro and in vivo experiments have provided mechanistic explanations for the atheroprotective effects of HDL. HDL not only mediates reverse cholesterol transport, but also exerts antioxidant, anti-inflammatory, antithrombotic and vasodilatory effects. These multiple antiatherosclerotic properties provide an excellent rationale for designing therapeutic interventions targeted at enhancing HDL/apoA-I levels, but also for considering a direct administration of HDL-apoA-I in a variety of cardiovascular diseases. We provide an overview and an update of all therapeutic applications of synthetic HDL tested in animal models or in clinical trials. HDL therapy has proven to be effective in promoting atherosclerosis regression not only in experimental models, but also in humans, whereas applications to other areas of cardiovascular disease have only, up to now, been tested in animal models.
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