| Dysfunctional high-density lipoprotein and atherosclerosis. | |
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MedLine Citation:
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PMID: 20506005 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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High-density lipoprotein (HDL) is well established as a negative risk factor for the development of atherosclerosis. Epidemiologic, pathologic, and experimental studies have demonstrated a role for HDL in protection from coronary artery disease. HDL has been demonstrated to reduce the risk from atherosclerosis by multiple pathophysiologic mechanisms. Low-density lipoprotein is a metabolic end product that can be recognized and cleared by specific hepatic receptors with excretion into the bile. However, low-density lipoprotein may also be scavenged in the periphery by the monocyte-macrophage system, with subsequent generation of lipid-laden foam cells. HDL may reduce the atherosclerotic burden by multiple potential mechanisms. HDL can interact with the foam cell to remove cholesterol via receptor-mediated binding, passive diffusion, and alteration of intracellular cholesterol trafficking by ATP binding cassettes. The process of reverse cholesterol transport is a major mechanism by which HDL can remove cholesterol from the periphery, allowing it to be cleared by the liver and then excreted into the bile. However, HDL exhibits multiple additional potential beneficial physiologic effects. Endothelial function and repair is potentiated by HDL. Normal HDL has significant anti-inflammatory and antioxidant activity. Prostacyclin production and improvement in fibrinolytic balance is also attributed to normally functioning HDL. HDL is also intimately related to the metabolism of other circulating lipoproteins. However, multiple clinical studies have identified individuals with a significant atherosclerotic burden despite normal or elevated levels of HDL cholesterol. Clinical conditions associated with inflammation and oxidative stress have adversely altered the normal functions of HDL. Clinical assays have been developed to assess the functionality of HDL. Dysfunctional HDL may be returned to normal by diet, exercise, degree of fat intake, and pharmacologic approaches. Orally active mimetic proteins are in development and have shown clinical promise. |
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Authors:
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Shawn Ragbir; John A Farmer |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current atherosclerosis reports Volume: 12 ISSN: 1534-6242 ISO Abbreviation: Curr Atheroscler Rep Publication Date: 2010 Sep |
Date Detail:
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Created Date: 2010-07-29 Completed Date: 2010-11-30 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 100897685 Medline TA: Curr Atheroscler Rep Country: United States |
Other Details:
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Languages: eng Pagination: 343-8 Citation Subset: IM |
Affiliation:
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Section of Cardiology, Department of Medicine, Baylor College of Medicine, One Baylor Plaza, Room 525D, Houston, TX 77030, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Atherosclerosis
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blood*,
etiology Disease Progression Dyslipidemias / blood, complications* Humans Lipoproteins, HDL / blood* Prognosis Risk Factors |
| Chemical | |
Reg. No./Substance:
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0/Lipoproteins, HDL |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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