LDL-cholesterol versus HDL-cholesterol in the atherosclerotic plaque: inflammatory resolution versus thrombotic chaos

Area of Science:

• Cardiovascular Biology
• Lipid Metabolism
• Vascular Medicine

Background:

• Atherosclerosis is a complex disease initiated and progressed by high serum low-density lipoprotein (LDL) levels.
• Despite effective LDL-lowering therapies, residual cardiovascular events remain a concern.
• High-density lipoproteins (HDL) offer protection by mitigating vascular damage, prompting interest in HDL-raising therapies.

Purpose of the Study:

• To elucidate the mechanisms of LDL in atherosclerosis development and thrombotic complications.
• To explore the role of functional HDL in resolving vascular chaos and preventing atherosclerosis progression.
• To highlight the importance of HDL quality over quantity for future therapeutic strategies.

Main Methods:

• Review of existing literature on LDL and HDL in atherosclerosis.
• Exploration of cellular and molecular mechanisms involved in vascular wall chaos induced by LDL.
• Analysis of HDL's protective functions against atherosclerosis progression and regression.

Main Results:

• Excess LDL significantly contributes to the initiation and progression of atherosclerosis and its complications.
• Functional HDL actively resolves vascular chaos through various cellular and molecular pathways.
• Evidence suggests HDL quality is a more critical therapeutic target than HDL quantity.

Conclusions:

• LDL acts as a primary instigator of vascular wall dysfunction in atherosclerosis.
• Functional HDL possesses potent atheroprotective properties, promoting disease resolution.
• Future pharmacological interventions should prioritize enhancing HDL functionality for optimal cardiovascular risk reduction.