A Novel Mechanism by which High Density Lipoprotein Selectively Delivers Cholesterol Esters to the Liver
One of the most dramatic developments in the epidemiologic investigation of coronary heart disease risk factors during the last decade has been the mushrooming evidence that a high level of HDL decreases while a low level of HDL increases the risk of clinical disease. A seminal paper by Miller and Miller in 1975  focused attention on this problem by pointing out the several risk factors for coronary heart disease that were associated with low levels of plasma HDL. Despite the high level of interest in this problem and the many studies that have been done, we still do not know exactly how this HDL-coronary heart disease relationship works. By all odds the most widely accepted hypothesis is that HDL serves the function of removing cholesterol from peripheral tissues and carrying it to the liver for reutilization or excretion in the bile . Many studies in cell culture show that HDL is capable of acting as an acceptor of cholesterol from cells overloaded with it [3–8]. On the other hand, delipidated serum is also able to facilitate the removal of cholesterol from cholesterol-loaded cells in culture . More direct evidence is needed before the role of HDL in reverse cholesterol transport can be considered established.
KeywordsCholesterol Lipase Heparin Trypsin Stein
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