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J Am Coll Cardiol, 2005; 46:1792-1798, doi:10.1016/j.jacc.2005.06.080 (Published online 18 October 2005).
© 2005 by the American College of Cardiology Foundation
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STATE-OF-THE-ART PAPER

High-Density Lipoprotein Function

Recent Advances

Benjamin J. Ansell, MD, FACC, Karol E. Watson, MD, PhD, Alan M. Fogelman, MD, FACC, Mohamad Navab, PhD and Gregg C. Fonarow, MD, FACC*

Atherosclerosis Research Unit, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California.

Manuscript received April 24, 2005; revised manuscript received May 29, 2005, accepted June 7, 2005.

* Reprint requests and correspondence: Dr. Gregg C. Fonarow, 47-123 CHS, 10833 LeConte Avenue, Los Angeles, California 90095. (Email: gfonarow{at}mednet.ucla.edu).

Although high-density lipoproteins (HDL) possess many features that contribute to the association between elevated HDL cholesterol and protection from atherosclerosis, these lipoproteins may be modified in certain individuals and/or circumstances to become proinflammatory. The ability of HDL to inhibit or paradoxically to enhance vascular inflammation, lipid oxidation, plaque growth, and thrombosis reflects changes in specific enzyme and protein components. The anti-inflammatory and proinflammatory functional properties of HDL can now be assessed using cell-based and cell-free assays. Acute or chronic systemic inflammation and the metabolic syndrome appear to render HDL proinflammatory. In contrast, statins and experimental agents such as apolipoprotein A-1 mimetics render HDL more anti-inflammatory. Functional characterization of HDL is a promising method for enhanced assessment of cardiovascular risk and effectiveness of risk reduction.

Abbreviations and Acronyms
  ABCA1 = adenosine triphosphate-binding cassette transporter A1
  apoA-1 = apolipoprotein A-1
  CETP = cholesteryl ester transfer protein
  CFA = cell-free assay
  CHD = coronary heart disease
  HDL = high-density lipoprotein
  HDL-C = high-density lipoprotein cholesterol
  LDL = low-density lipoprotein
  MCA = monocyte chemotaxis assay
  MCP = monocyte chemotaxis protein
  ox-LDL = oxidized low-density lipoprotein




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