Dysfunctional HDL: a novel important diagnostic and therapeutic target in cardiovascular disease?

Area of Science:

• Cardiovascular Science
• Lipid Metabolism
• Inflammation Biology

Background:

• High density lipoprotein (HDL) is known for its atheroprotective properties.
• Clinical trials show atherosclerosis progression despite normal HDL cholesterol levels, questioning HDL's universal protective role.
• Inflammation can alter HDL structure and function, potentially making it proinflammatory.

Purpose of the Study:

• To review the current understanding of HDL properties.
• To investigate factors and therapeutic agents that may prevent HDL dysfunction.
• To address whether HDL-raising therapies impact HDL quality.

Main Methods:

• Literature review of current research on HDL properties and dysfunction.
• Analysis of studies investigating inflammation's impact on HDL.
• Examination of therapeutic strategies affecting HDL quality.

Main Results:

• HDL subfractions may possess different properties.
• Inflammation can induce structural and functional changes in HDL, leading to a proinflammatory state.
• The effect of HDL-raising therapies on HDL quality remains unclear.

Conclusions:

• HDL's atheroprotective role may be compromised by dysfunction.
• Understanding factors that transform HDL into dysfunctional particles is crucial.
• Further research is needed to determine if current therapies improve HDL quality.