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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
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Roles of HDL function and sphingosine-1-phosphate in vasospastic angina.

Kei Sasaki1, Hirotaka Ezaki2, Yasuhiro Endo3

  • 1Division of Anti-aging and Vascular Medicine, Department of Internal Medicine, National Defense Medical College, Tokorozawa, Saitama, Japan.

Clinica Chimica Acta; International Journal of Clinical Chemistry
|May 4, 2025
PubMed
Summary

This study reveals that reduced cholesterol uptake capacity (CUC) indicates dysfunctional high-density lipoprotein (HDL) in vasospastic angina (VSA). Elevated sphingosine-1-phosphate (S1P) levels are also linked to VSA, suggesting potential biomarkers.

Keywords:
Cholesterol uptake capacity (CUC)HDL functionHigh-density lipoprotein (HDL)Sphingosine-1-phosphate (S1P)Vasospastic angina (VSA)

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Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Lipid Metabolism

Background:

  • High-density lipoprotein cholesterol (HDL-C) is often reduced in vasospastic angina (VSA), but HDL functionality's role is unclear.
  • Cholesterol uptake capacity (CUC) measures HDL functionality via cholesterol efflux.
  • Sphingosine-1-phosphate (S1P), an HDL-associated lipid, has vasoprotective properties potentially relevant to VSA.

Purpose of the Study:

  • To evaluate cholesterol uptake capacity (CUC) in patients with VSA.
  • To assess serum levels of sphingosine-1-phosphate (S1P) in VSA patients.
  • To explore the relationship between HDL functionality, S1P, and VSA pathogenesis.

Main Methods:

  • Seventy-seven patients were included: 32 VSA, 21 non-VSA (undergoing acetylcholine provocation test), and 24 VSA outpatients.
  • Cholesterol uptake capacity (CUC) was measured using a cell-free assay.
  • Serum S1P levels were quantified and analyzed for association with VSA.

Main Results:

  • VSA patients showed lower CUC compared to non-VSA patients.
  • Serum S1P levels were significantly elevated in VSA patients (1.74 ± 0.76 µM vs. 1.31 ± 0.49 µM).
  • Elevated S1P levels were significantly associated with VSA (OR = 3.14, p = 0.01), even after adjustment.

Conclusions:

  • Reduced CUC is a novel indicator of HDL dysfunction in VSA.
  • S1P is a promising biomarker for treated VSA patients.
  • Cholesterol efflux pathways and sphingolipid metabolism may contribute to VSA etiology.