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High-Density Lipoprotein Function and Dysfunction in Health and Disease

Scott T Chiesa1, Marietta Charakida2,3

  • 1Vascular Physiology Unit, UCL Institute of Cardiovascular Science, 1 St. Martin's Le Grand, London, EC1A 4NP, UK. s.chiesa@ucl.ac.uk.

Cardiovascular Drugs and Therapy
|January 25, 2019
PubMed

Insights

High-density lipoprotein cholesterol (HDL-c) may not be protective against cardiovascular disease (CVD). HDL

Area of Science:

  • Cardiovascular Science
  • Lipid Metabolism
  • Inflammation Biology

Background:

  • High-density lipoprotein cholesterol (HDL-c) traditionally termed 'good cholesterol' shows an inverse relationship with cardiovascular disease (CVD) risk.
  • Recent genetic studies and randomized controlled trials challenge HDL-c's causal role in cardiovascular protection.
  • Emerging research shifts focus from HDL-c levels to the functional properties of HDL particles.

Purpose of the Study:

  • To review the relationship between HDL and CVD risk.
  • To explore how chronic inflammation alters HDL composition and function.
  • To discuss potential therapeutic interventions targeting HDL.

Main Methods:

  • Literature review of genetic studies.
  • Analysis of large-scale randomized controlled trials.
  • Examination of evidence on HDL composition and function in inflammatory conditions.

Main Results:

  • Evidence suggests HDL-c levels do not causally protect against CVD.
  • HDL particle composition and function are altered in inflammatory states.
  • Altered HDL may transition from a protective to a pro-atherogenic particle.

Conclusions:

  • The protective role of HDL against CVD is questionable.
  • Inflammation significantly impacts HDL functionality, potentially promoting atherosclerosis.
  • Future therapies may focus on modulating HDL function rather than just increasing levels.

Keywords:
AtherosclerosisCardiovascular diseaseHDL dysfunctionInflammation

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