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Review
. 2021 Oct 1;32(5):315-322.
doi: 10.1097/MOL.0000000000000782.

HDL and persistent inflammation immunosuppression and catabolism syndrome

Grant Barker  1 , Julia R Winer  2 , Faheem W Guirgis  1 , Srinivasa Reddy  3
Affiliations
Review

HDL and persistent inflammation immunosuppression and catabolism syndrome

Grant Barker et al. Curr Opin Lipidol. .

Abstract

Purpose of review: This study reviews the mechanisms of HDL cholesterol immunomodulation in the context of the mechanisms of chronic inflammation and immunosuppression causing persistent inflammation, immunosuppression and catabolism syndrome (PICS) and describes potential therapies and gaps in current research.

Recent findings: Low HDL cholesterol is predictive of acute sepsis severity and outcome. Recent research has indicated apolipoprotein is a prognostic indicator of long-term outcomes. The pathobiologic mechanisms of PICS have been elucidated in the past several years. Recent research of the interaction of HDL pathways in related chronic inflammatory diseases may provide insights into further mechanisms and therapeutic targets.

Summary: HDL significantly influences innate and adaptive immune pathways relating to chronic disease and inflammation. Further research is needed to better characterize these interactions in the setting of PICS.

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Conflict of interest statement

Conflicts of Interest:

The authors have no conflicts of interest to disclose.

Figures

FIGURE 1
FIGURE 1
Not only is HDL quantitatively affected in inflammatory disease, but the makeup of its lipids and associated enzymes are fundamentally changed. Future research should place emphasis on characterizing these changes in PICS as well as thoughtfully considering the temporality of immune changes in the septic response. Namely, the early appropriate level of inflammation followed by a timely resolution. As sepsis is a disorder of heterogenous causes (gram positive, gram negative, surgical, respiratory, urinary, etc.), characterization of biomarkers and lipid levels may additionally help to appropriately select patients for treatment.
See this image and copyright information in PMC

References

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