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[Interaction of cholesterol in plasma and cholesterol in the vessel wall]
1Institute of Biochemistry, Royal Infirmary, Glasgow, Scotland, UK.
Insights
High cholesterol, particularly LDL cholesterol, is linked to coronary heart disease. Lipid-lowering therapy can regress arterial lesions by understanding reverse cholesterol transport.
Area of Science:
- Cardiovascular Science
- Biochemistry
- Epidemiology
Context:
- Cholesterol is a key component in arterial wall degenerative lesions.
- Epidemiological studies link plasma cholesterol, especially LDL cholesterol, to coronary heart disease risk.
Purpose:
- To investigate the interactions between LDL and arterial wall cells.
- To elucidate the mechanisms of atherosclerotic lesion formation and regression.
Summary:
- Increased LDL cholesterol concentrations initiate atherosclerotic lesion formation.
- Lesion progression involves continuous lipid accumulation and altered free/esterified cholesterol balance.
- Lipid-lowering therapy can induce regression of advanced atherosclerotic lesions.
Impact:
- Provides a model for early atherosclerotic lesion formation.
- Highlights the role of reverse cholesterol transport in lesion regression.
- Informs therapeutic strategies for managing cardiovascular disease risk.
Abstract:
It has been known for a long time that cholesterol is an important constituent of degenerative lesions of the arterial wall. During the last 20 years epidemiological studies have shown that the risk for coronary heart disease is strongly correlated with the plasma levels of cholesterol and in particular with LDL (low density lipoprotein) cholesterol. The interactions between LDL and cells of the arterial wall have been investigated and recent findings suggest a model which explains the formation of early atherosclerotic lesions starting from increased LDL cholesterol concentrations. Further progression of lesions is characterised by continuous lipid accumulation with a relative increase of free cholesterol at the expense of cholesteryl esters. Regression even of advanced lesions can be achieved by vigorous lipid lowering therapy. The mechanisms of "reverse cholesterol transport" involved in this process are now understood to some extent.