title: The dual nature of HDL: Anti-Inflammatory and pro-Inflammatory.
abstract: High density lipoprotein (HDL) has long been considered a protective factor against the development of coronary heart disease. Two important roles of HDL include reverse cholesterol transport (RCT) and the modulation of inflammation. The main protein component of HDL; apolipoprotein A-I (apo A-I) is primarily responsible for RCT. Apo A-I can be damaged by oxidative mechanisms, which reduce the protein's ability to promote RCT. In disease states such as diabetes, associated with a chronic acute-phase response, HDL has been found to be dysfunctional and pro-inflammatory. HDL cholesterol levels do not predict composition and/or function and therefore it is important to evaluate the quality and not just the quantity of HDL cholesterol when considering the risk of cardiovascular events. In clinical practice, there are currently no widely available tests for measuring the composition, functionality, and inflammatory properties of HDL. Small peptides that mimic some of the properties of apo A-I have been shown in pre-clinical models to improve HDL function and reduce atherosclerosis without altering HDL cholesterol levels. Clinical trials using HDL and HDL mimetics as therapeutic agents are currently underway. Results in animal studies and early clinical trials will be reviewed.
authors.affiliation: Departments of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Ryan
authors.initials: R
authors.lastname: Namiri-Kalantari
authors.affiliation: Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Feng
authors.initials: F
authors.lastname: Gao
authors.affiliation: Departments of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Arnab
authors.initials: A
authors.lastname: Chattopadhyay
authors.affiliation: Departments of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Aerin Alese
authors.initials: AA
authors.lastname: Wheeler
authors.affiliation: Departments of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Kaveh D
authors.initials: KD
authors.lastname: Navab
authors.affiliation: Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Robin
authors.initials: R
authors.lastname: Farias-Eisner
authors.affiliation: Departments of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.|Obstetrics and Gynecology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.|Molecular and Medical Pharmacology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
authors.forename: Srinivasa T
authors.initials: ST
authors.lastname: Reddy
mesh_terms: D000818:Animals; D000893:Anti-Inflammatory Agents / Q000378:metabolism* / Q000627:therapeutic use; D016632:Apolipoprotein A-I / Q000378:metabolism; D050197:Atherosclerosis / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D001692:Biological Transport; D002784:Cholesterol / Q000378:metabolism; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D003920:Diabetes Mellitus / Q000188:drug therapy / Q000378:metabolism* / Q000473:pathology; D006801:Humans; D007249:Inflammation; D008075:Lipoproteins, HDL / Q000378:metabolism* / Q000627:therapeutic use; D010084:Oxidation-Reduction; D010455:Peptides / Q000378:metabolism / Q000627:therapeutic use; D057786:Peptidomimetics / Q000378:metabolism / Q000627:therapeutic use; D012307:Risk Factors
chemical_list: D000893:Anti-Inflammatory Agents; D016632:Apolipoprotein A-I; D008075:Lipoproteins, HDL; D010455:Peptides; D057786:Peptidomimetics; D002784:Cholesterol
keywords: HDL; HDL inflammatory index (HII); LDL; anti-inflammatory HDL; apo A-I mimetic peptides; apolipoprotein A-I (apo A-I); coronary heart disease (CHD); pro-inflammatory HDL