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Published on: October 12, 2017
Atherosclerosis regression and high-density lipoproteins
Justin M S Lee1, Robin P Choudhury
1Department of Cardiology, Papworth Hospital, Cambridge, UK.
Insights
Atherosclerosis regression is achievable, with high-density lipoprotein (HDL) targeting agents showing promise for future treatments. Current research explores HDL
Area of Science:
- Cardiovascular Research
- Lipid Metabolism
- Arterial Wall Imaging
Background:
- Atherosclerosis regression is established in animal models and human studies.
- Arterial wall imaging advances understanding of regression.
- Low-density lipoprotein (LDL) lowering is the primary lipid treatment.
Purpose of the Study:
- To explore the potential of high-density lipoprotein (HDL) targeting agents as a next-generation treatment for atherosclerotic disease.
- To review current and future therapeutic strategies for HDL modulation.
Main Methods:
- Review of existing literature on atherosclerosis regression.
- Analysis of the antiatherosclerotic functions of HDL, including reverse cholesterol transport.
- Examination of current agents with documented effects and ongoing clinical trials.
Main Results:
- HDL possesses multiple antiatherosclerotic functions beyond reverse cholesterol transport.
- Nicotinic acid demonstrates documented antiatherosclerotic effects.
- Clinical trials are evaluating HDL-targeting agents in contemporary LDL treatment settings.
Conclusions:
- Targeting HDL represents a promising future direction for atherosclerotic disease treatment.
- Cholesteryl ester transfer protein inhibitors and apolipoprotein A-I mimetics are potential future HDL-based therapies.
Abstract:
Atherosclerosis regression has been demonstrated clearly in animal experimental models and, to a lesser extent, in human clinical studies. Imaging techniques for study of the arterial wall are playing a key role in promoting our appreciation of regression. LDL lowering remains the mainstay of current lipid treatment, but given the multiple antiatherosclerotic functions of HDL, including reverse cholesterol transport, agents that target HDL may represent the next generation of treatment for atherosclerotic disease. Currently available agents, including nicotinic acid, have documented antiatherosclerotic effects and trials examining clinical outcomes in the context of contemporary LDL treatment are now underway. Future approaches to HDL treatment may include cholesteryl ester transfer protein inhibitors and apolipoprotein A-I mimetics.
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