Current concept of reverse cholesterol transport and novel strategy for atheroprotection.
Elevated levels of low-density lipoprotein cholesterol (LDL-C) increase the risk of coronary heart disease (CHD), but pharmacologic therapy to decrease LDL-C significantly reduces the risk of cardiovascular events. Despite the effectiveness of statin therapy, there remains significant residual cardiovascular risk. A low plasma concentration of high-density lipoprotein cholesterol (HDL-C) is associated with increased risk of CHD. Moreover, recent studies have shown that HDL-C levels during statin treatment remain an independent predictor of the risk of cardiovascular events. However, recent clinical trials aimed at reducing CHD risk by raising HDL-C levels have not shown satisfactory results and it is becoming evident that a functional HDL-C is a more desirable target than simply elevating its level. This review summarizes the function of HDL-C in reverse cholesterol transfer from peripheral tissue and discusses the latest HDL-targeting therapeutic strategies including the manipulation of microRNAs.
Department of Cardiovascular Medicine, Graduate School of Medicine, Kyoto University, Kyoto 606-8507, Japan. kohono@kuhp.kyoto-u.ac.jp
Koh
K
Ono
D000818:Animals; D050197:Atherosclerosis / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000378:metabolism* / Q000502:physiology; D008078:Cholesterol, LDL / Q000378:metabolism; D003327:Coronary Disease / Q000517:prevention & control*; D050171:Dyslipidemias / Q000188:drug therapy / Q000378:metabolism; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D008264:Macrophages / Q000378:metabolism; D035683:MicroRNAs; D058990:Molecular Targeted Therapy
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D035683:MicroRNAs