Abstract
Several epidemiological and clinical studies have demonstrated the inverse correlation between the plasma concentration of high density lipoprotein (HDL) cholesterol and the risk of myocardial infarction (reviewed in ref. 1). The ability of HDL to protect the vessel wall from atherosclerosis has usually been explained by the reverse cholesterol transport model (reviewed in ref. 2) in which HDL mediates the flux of excess cholesterol from peripheral cells to the liver. HDL-cholesterol levels are determined by environmental and genetic factors. The influence of genes on the variation of HDL-cholesterol levels has been estimated to account for up to 50%, but only rare defects in the genes of apolipoprotein (apo)A-I and lecithin:cholesterol acyltransferase (LCAT) could be made responsible for familially low HDL-cholesterol levels3. Despite the virtual absence of HDL, several homozygotes for apoA-I deficiency, LCAT deficiency, and fish-eye disease, but also patients with Tangier disease or unclassified forms of HDL deficiency did not present with premature atherosclerosis3–6. Family histories of these patients did not indicate any increased prevalence of coronary heart disease (CHD) events, although heterozygotes for various defects in the genes of apoA-I and LCAT, as well as obligate heterozygotes for Tangier disease, usually have HDL-cholesterol levels below the 10th percentile of sex- and age- matched controls3,5,6. These clinical observations have questioned a direct anti-atherogenic role of HDL. HDL, however, include structurally and functionally heterogeneous lipoproteins which can be differentiated on the basis of density, size, charge and apolipoprotein composition7. During recent years, experiments of our and other investigators’ laboratories have yielded a large body of evidence showing that minor subtractions of HDL which escape the quantification of HDL-cholesterol are important contributors to reverse cholesterol transport.
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von Eckardstein, A., Huang, Y., Assmann, G. (1995). Role of high density lipoprotein subclasses in reverse cholesterol transport. In: Assmann, G. (eds) HDL Deficiency and Atherosclerosis. Developments in Cardiovascular Medicine, vol 174. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-6585-3_2
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DOI: https://doi.org/10.1007/978-94-011-6585-3_2
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