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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2006;26:1687.)
© 2006 American Heart Association, Inc.

Editorials

Understanding Changes in High Density Lipoproteins During the Acute Phase Response

Brian J. Van Lenten; Srinivasa T. Reddy; Mohamad Navab; Alan M. Fogelman

From the Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA.

Correspondence to Brian J. Van Lenten, PhD, Room BH-307 CHS, Division of Cardiology, Department of Medicine, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, Los Angeles, CA 90095-1679. E-mail BvanLent@mednet.ucla.edu

An extract of the first 250 words of the full text is provided, because this article has no abstract.

During infection and inflammation there is a cascade of reactions that occurs in the host collectively known as the acute-phase response (APR).¹ Besides alterations in acute-phase reactants (plasma proteins), the APR is also associated with changes in lipoproteins.² Increasing evidence suggests that high density lipoproteins (HDL) are a critical part of the acute phase response (APR) of the innate immune system.³ During infection and inflammation, there is a reduction in levels of several plasma proteins involved in HDL-mediated reverse cholesterol transport and inhibiting plasma lipid oxidation, such as lecithin:cholesterol acyltransferase (LCAT), cholesterol ester transfer protein, phospholipid transfer protein, hepatic lipase, apolipoprotein A-I (apoA-I), and paraoxonase (PON).² Moreover, the composition of circulating HDL during an APR, also known as acute-phase HDL, is altered. Analysis of the lipid composition shows that acute-phase HDL is depleted in cholesterol ester but enriched in free cholesterol, triglyceride, and free tty acids.⁴ Changes in the phospholipid content of acute-phase HDL was shown to be more variable, having increased in one study⁵ but decreased in another.⁶ The levels of apolipoprotein J (apoJ or clusterin) and serum amyloid A (SAA) increase several fold in acute-phase HDL.⁷ Because of the marked changes in HDL during an APR, acute-phase HDL behaves differently from normal HDL in terms of its protective effect against atherosclerosis.⁸ Malle and coworkers have shown that acute-phase HDL was less effective in removing cholesterol from macrophages.⁹ Delivery of cholesterol ester to hepatocytes is also decreased during an APR because of changes in HDL composition and a reduction . . . [Full Text of this Article]

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