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Review
. 2019 Jan-Mar;15(1):9-15.
doi: 10.14797/mdcj-15-1-9.

Cholesterol: Can't Live With It, Can't Live Without It

Henry J Pownall  1 , Antonio M Gotto Jr  1
Affiliations
Review

Cholesterol: Can't Live With It, Can't Live Without It

Henry J Pownall et al. Methodist Debakey Cardiovasc J. 2019 Jan-Mar.

Abstract

Given its role in many biochemical processes essential to life, cholesterol remains a topic of intense research. Of all the plasma lipids, cholesterol is distinctive because it is a precursor to steroidogenic molecules, some of which regulate metabolism, and its blood concentration in the form of low- and high-density lipoprotein cholesterol (HDL-C) are positive and negative risk factors for atherosclerotic cardiovascular disease (ASCVD). New research, however, has challenged the widely held belief that high HDL-C levels are atheroprotective and is showing that both low and high plasma HDL-C levels confer an increased risk of ASCVD. Furthermore, it is disputing the widely cited mechanism involved in reverse cholesterol transport. This review explores the evolution of cholesterol research starting with the Gofman and Framingham studies, the development of traditional and emerging lipid-lowering therapies, and the role of reverse cholesterol transport in HDL cardioprotection.

Keywords: atherogenesis; lipid risk factors; lipid therapeutics; lipoproteins; reverse cholesterol transport.

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Conflict of interest statement

Conflict of Interest Disclosure: Dr. Gotto is a consultant for Esperion and KOWA Pharmaceuticals America, Inc., and is on the Data Safety Monitoring Board for Ionis Pharmaceuticals.

Figures

Figure 1.
Figure 1.
Schematic representation of the Glomset/Ross model of reverse cholesterol transport comprises three steps. (1) Formation of nHDL via the interaction of apolipoprotein AI with the macrophage ABCA1 transporter; direct transfer of cholesterol to HDL via ABCG4 is also shown. (2) FC esterification by LCAT to give a mature spherical form of HDL. (3) Transfer of HDL lipids to liver hepatocytes via SR-B1. nHDL: nascent high-density lipoprotein; ABCA1: ATP-binding cassette transporter; ABCG1/4: ATP-binding cassette subfamily G member 1 and 4; FC: free cholesterol; LCAT: lecithin:cholesterol acyltransferase; SR-B1: scavenger receptor class B type 1
See this image and copyright information in PMC

References

    1. Hatch FT, Lindgren FT, Adamson GL, Jensen LC, Wong AW, Levy RI. Quantitative agarose gel electrophoresis of plasma lipoproteins: a simple technique and two methods for standardization. J Lab Clin Med. 1973 Jun;81(6):946–60. - PubMed
    1. Gofman JW, Young W, Tandy R. Ischemic heart disease, atherosclerosis, and longevity. Circulation. 1966 Oct;34(4):679–97. - PubMed
    1. Burstein M, Scholnick HR, Morfin R. Rapid method for the isolation of lipoproteins from human serum by precipitation with polyanions. J Lipid Res. 1970 Nov;11(6):583–95. - PubMed
    1. Rudel LL, Lee JA, Morris MD, Felts JM. Characterization of plasma lipoproteins separated and purified by agarose-column chromatography. Biochem J. 1974 Apr;139(1):89–95. - PMC - PubMed
    1. Foreman JR, Karlin JB, Edelstein C, Juhn DJ, Rubenstein AH, Scanu AM. Fractionation of human serum lipoproteins by single-spin gradient ultracentrifugation: quantification of apolipoproteins B and A-1 and lipid components. J Lipid Res. 1977 Nov;18(6):759–67. - PubMed

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