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Review |
1 Institute for Translational Medicine and Therapeutics and Cardiovascular Institute; University of Pennsylvania School of Medicine, Philadelphia, PA.
aAddress correspondence to this author at: Institute for Translational Medicine and Therapeutics, University of Pennsylvania Medical Center, 654 BRBII/III labs, 421 Curie Blvd, Philadelphia, PA 19104-6160. Fax 215-573-8606; e-mail rader{at}mail.med.upenn.edu.
Background: Plasma concentrations of HDL cholesterol (HDL-C) and its major protein component apolipoprotein (apo) A-I are strongly inversely associated with cardiovascular risk, leading to the concept that therapy to increase HDL-C and apoA-I concentrations would be antiatherosclerotic and protective against cardiovascular events. The recent failure of the drug torcetrapib, a cholesteryl ester transfer protein inhibitor that substantially increased HDL-C concentrations, has brought focus on the issues of HDL heterogeneity and function as distinct from HDL-C concentrations.
Content: This review addresses the current state of knowledge regarding assays of HDL heterogeneity and function and their relationship to cardiovascular disease. HDL is highly heterogeneous, with subfractions that can be identified on the basis of density, size, charge, and protein composition, and the concept that certain subfractions of HDL may be better predictors of cardiovascular risk is attractive. In addition, HDL has been shown to have a variety of functions that may contribute to its cardiovascular protective effects, including promotion of macrophage cholesterol efflux and reverse cholesterol transport and antiinflammatory and nitric oxide–promoting effects.
Summary: Robust laboratory assays of HDL subfractions and functions and validation of the usefulness of these assays for predicting cardiovascular risk and assessing response to therapeutic interventions are critically important and of great interest to cardiovascular clinicians and investigators and clinical chemists.
The following articles in journals at HighWire Press have cited this article:
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  L. Duvillard, G. Dautin, E. Florentin, A. Jeannin, J.-P. Pais de Barros, L. Lagrost, J.-M. Petit, P. Gambert, and B. Verges Increased Apolipoprotein AI Production Rate and Redistribution of High-Density Lipoprotein Size Induced by Estrogen plus Progestin as Oral Contraceptive J. Clin. Endocrinol. Metab., December 1, 2009; 94(12): 4891 - 4897. [Abstract] [Full Text] [PDF]
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 H. Zhou, S. W. Shiu, Y. Wong, and K. C. Tan Impaired serum capacity to induce cholesterol efflux is associated with endothelial dysfunction in type 2 diabetes mellitus Diabetes and Vascular Disease Research, October 1, 2009; 6(4): 238 - 243. [Abstract] [PDF]
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 J. B. Massey, H. J. Pownall, S. Macha, J. Morris, M. R. Tubb, and R. A. G. D. Silva Mass spectrometric determination of apolipoprotein molecular stoichiometry in reconstituted high density lipoprotein particles J. Lipid Res., June 1, 2009; 50(6): 1229 - 1236. [Abstract] [Full Text] [PDF]
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 M. Y. Tsai, N. Li, A. R. Sharrett, S. Shea, D. R. Jacobs Jr, R. Tracy, D. Arnett, V. Arends, and W. Post Associations of Genetic Variants in ATP-Binding Cassette A1 and Cholesteryl Ester Transfer Protein and Differences in Lipoprotein Subclasses in the Multi-Ethnic Study of Atherosclerosis Clin. Chem., March 1, 2009; 55(3): 481 - 488. [Abstract] [Full Text] [PDF]
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S. Sankaranarayanan, J. F. Oram, B. F. Asztalos, A. M. Vaughan, S. Lund-Katz, M. P. Adorni, M. C. Phillips, and G. H. Rothblat Effects of acceptor composition and mechanism of ABCG1-mediated cellular free cholesterol efflux J. Lipid Res., February 1, 2009; 50(2): 275 - 284. [Abstract] [Full Text] [PDF]
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