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. 2023 Jan 16:36:10841.
doi: 10.3389/ti.2023.10841. eCollection 2023.

Low HDL-Cholesterol Concentrations in Lung Transplant Candidates are Strongly Associated With One-Year Mortality After Lung Transplantation

Sébastien Tanaka  1   2 , Christian De Tymowski  1   3 , Alexy Tran-Dinh  1   4   5 , Olivier Meilhac  2   6 , Brice Lortat-Jacob  1 , Nathalie Zappella  1 , Sylvain Jean-Baptiste  1 , Tiphaine Robert  7 , Tiphaine Goletto  8 , Cendrine Godet  8   9 , Yves Castier  4   5   10 , Hervé Mal  4   8   9 , Pierre Mordant  4   5   10 , Enora Atchade  1 , Jonathan Messika  4   8   9   11 , Philippe Montravers  1   4   9 ; Bichat Lung Transplant Group
Collaborators, Affiliations

Low HDL-Cholesterol Concentrations in Lung Transplant Candidates are Strongly Associated With One-Year Mortality After Lung Transplantation

Sébastien Tanaka et al. Transpl Int. .

Abstract

High-density lipoproteins (HDLs), whose main role is the reverse transport of cholesterol, also have pleiotropic anti-inflammatory, antioxidant, anti-apoptotic and anti-infectious properties. During sepsis, HDL cholesterol (HDL-C) concentration is low, HDL particle functionality is altered, and these modifications are correlated with poor outcomes. Based on the protective effects of HDL, we hypothesized that HDL-C levels could be associated with lung transplantation (LT) outcome. We thus looked for an association between basal HDL-C concentration and one-year mortality after LT. In this single-center prospective study including consecutive LTs from 2015 to 2020, 215 patients were included, essentially pulmonary fibrosis (47%) and chronic obstructive pulmonary disease (COPD) (38%) patients. Mortality rate at one-year was 23%. Basal HDL-C concentration stratified nonsurvivors to survivors at one-year (HDL-C = 1.26 [1.12-1.62] mmol/L vs. HDL-C = 1.55 [1.22-1.97] mmol/L, p = 0.006). Multivariate analysis confirmed that HDL-C concentration during the pretransplant assessment period was the only variable inversely associated with mortality. Moreover, mortality at one-year in patients with HDL-C concentrations ≤1.45 mmol/L was significantly higher (log-rank test, p = 0.00085). In conclusion, low basal HDL-C concentrations in candidates for LT are strongly associated with mortality after LT. To better understand this association, further studies in this field are essential and, in particular, a better characterization of HDL particles seems necessary.

Keywords: HDL-cholesterol; lipoprotein; lung transplantation; mortality; outcome.

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Conflict of interest statement

CG reports having received grant support from Ohre Pharma, Pfizer, MSD, SOS Oxygène, ISIS Medical, Vivisol, Elivie and AstraZeneca, speaker fees, travel support from Pfizer, MSD and speaker fees for board memberships from SOS Oxygène and Pulmatrix. JM received congress reimbursement fees from Biotest and CSL Behring, Fingers Xed. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
survival rate at 1 year as a function of HDL-C concentrations according to HDL-C threshold (HDL-C = 1.45 mmol/L).
FIGURE 2
FIGURE 2
survival rate at 1-year as a function of HDL-C concentrations according to HDL-C threshold (HDL-C = 1.45 mmol/L) in the COPD (A) and in fibrosis (B) sub-groups.
See this image and copyright information in PMC

References

    1. Nofer JR, Levkau B, Wolinska I, Junker R, Fobker M, von Eckardstein A, et al. Suppression of Endothelial Cell Apoptosis by High Density Lipoproteins (HDL) and HDL-Associated Lysosphingolipids. J Biol Chem (2001) 276(37):34480–5. 10.1074/jbc.M103782200 - DOI - PubMed
    1. Wilson PW, Abbott RD, Castelli WP. High Density Lipoprotein Cholesterol and Mortality. The Framingham Heart Study. Framingham Heart Study Arteriosclerosis Déc (1988) 8(6):737–41. 10.1161/01.atv.8.6.737 - DOI - PubMed
    1. Cooney MT, Dudina A, De Bacquer D, Wilhelmsen L, Sans S, Menotti A, et al. HDL Cholesterol Protects against Cardiovascular Disease in Both Genders, at All Ages and at All Levels of Risk. Atheroscler oct (2009) 206(2):611–6. 10.1016/j.atherosclerosis.2009.02.041 - DOI - PubMed
    1. Pirillo A, Catapano AL, Norata GD. HDL in Infectious Diseases and Sepsis. Handb Exp Pharmacol (2015) 224:483–508. 10.1007/978-3-319-09665-0_15 - DOI - PubMed
    1. Tran-Dinh A, Diallo D, Delbosc S, Varela-Perez LM, Dang QB, Lapergue B, et al. HDL and Endothelial protection. Br J Pharmacol Juin (2013) 169(3):493–511. 10.1111/bph.12174 - DOI - PMC - PubMed