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on January 23, 2003

Arteriosclerosis, Thrombosis, and Vascular Biology. 2003
Published online before print January 23, 2003, doi: 10.1161/01.ATV.0000057572.97137.DD
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Submitted on October 29, 2002
Accepted on January 13, 2003

Importance of Different Pathways of Cellular Cholesterol Efflux

Patricia G. Yancey ; Anna E. Bortnick ; Ginny Kellner-Weibel ; Margarita de la Llera-Moya ; Michael C. Phillips ; and George H. Rothblat *

From the Division of Gastroenterology and Nutrition, Department of Pediatrics, Children's Hospital of Philadelphia, University of Pennsylvania School Medicine, Philadelphia, Pa.

* To whom correspondence should be addressed. E-mail: rothblat{at}email.chop.edu.

Abstract--The removal of excess free cholesterol from cells by HDL or its apolipoproteins is important for maintaining cellular cholesterol homeostasis. This process is most likely compromised in the atherosclerotic lesion because the development of atherosclerosis is associated with low HDL cholesterol. Multiple mechanisms for efflux of cell cholesterol exist. Efflux of free cholesterol via aqueous diffusion occurs with all cell types but is inefficient. Efflux of cholesterol is accelerated when scavenger receptor class-B type I (SR-BI) is present in the cell plasma membrane. Both diffusion-mediated and SR-BI-mediated efflux occur to phospholipid-containing acceptors (ie, HDL and lipidated apolipoproteins); in both cases, the flux of cholesterol is bidirectional, with the direction of net flux depending on the cholesterol gradient. The ATP-binding cassette transporter AI (ABCA1) mediates efflux of both cellular cholesterol and phospholipid. In contrast to SR-BI-mediated flux, efflux via ABCA1 is unidirectional, occurring to lipid-poor apolipoproteins. The relative importance of the SR-BI and ABCA1 efflux pathways in preventing the development of atherosclerotic plaque is not known but will depend on the expression levels of the two proteins and on the type of cholesterol acceptors available.


Key words: cholesterol efflux • scavenger receptor class-BI • ATP-binding cassette transporter AI • reverse cholesterol transport




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Am. J. Pathol.Home page
M. Van Eck, I. S. T. Bos, R. B. Hildebrand, B. T. Van Rij, and T. J.C. Van Berkel
Dual Role for Scavenger Receptor Class B, Type I on Bone Marrow-Derived Cells in Atherosclerotic Lesion Development
Am. J. Pathol., September 1, 2004; 165(3): 785 - 794.
[Abstract] [Full Text] [PDF]


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Proc. Natl. Acad. Sci. USAHome page
Y. Lange, J. Ye, and T. L. Steck
How cholesterol homeostasis is regulated by plasma membrane cholesterol in excess of phospholipids
PNAS, August 10, 2004; 101(32): 11664 - 11667.
[Abstract] [Full Text] [PDF]


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Proc. Natl. Acad. Sci. USAHome page
N. Wang, D. Lan, W. Chen, F. Matsuura, and A. R. Tall
ATP-binding cassette transporters G1 and G4 mediate cellular cholesterol efflux to high-density lipoproteins
PNAS, June 29, 2004; 101(26): 9774 - 9779.
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J. Biol. Chem.Home page
H. Saito, P. Dhanasekaran, D. Nguyen, E. Deridder, P. Holvoet, S. Lund-Katz, and M. C. Phillips
{alpha}-Helix Formation Is Required for High Affinity Binding of Human Apolipoprotein A-I to Lipids
J. Biol. Chem., May 14, 2004; 279(20): 20974 - 20981.
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Arterioscler. Thromb. Vasc. Bio.Home page
D.-A. Tregouet, S. Ricard, V. Nicaud, I. Arnould, S. Soubigou, M. Rosier, N. Duverger, O. Poirier, S. Mace, F. Kee, et al.
In-Depth Haplotype Analysis of ABCA1 Gene Polymorphisms in Relation to Plasma ApoA1 Levels and Myocardial Infarction
Arterioscler Thromb Vasc Biol, April 1, 2004; 24(4): 775 - 781.
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J. Biol. Chem.Home page
E. Favari, M. Lee, L. Calabresi, G. Franceschini, F. Zimetti, F. Bernini, and P. T. Kovanen
Depletion of Pre-{beta}-high Density Lipoprotein by Human Chymase Impairs ATP-binding Cassette Transporter A1- but Not Scavenger Receptor Class B Type I-mediated Lipid Efflux to High Density Lipoprotein
J. Biol. Chem., March 12, 2004; 279(11): 9930 - 9936.
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Arterioscler. Thromb. Vasc. Bio.Home page
H. B. Brewer Jr.
High-Density Lipoproteins: A New Potential Therapeutic Target for the Prevention of Cardiovascular Disease
Arterioscler Thromb Vasc Biol, March 1, 2004; 24(3): 387 - 391.
[Full Text]


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Arterioscler. Thromb. Vasc. Bio.Home page
K.-A. Rye and P. J. Barter
Formation and Metabolism of Prebeta-Migrating, Lipid-Poor Apolipoprotein A-I
Arterioscler Thromb Vasc Biol, March 1, 2004; 24(3): 421 - 428.
[Abstract] [Full Text]


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J. Pharmacol. Exp. Ther.Home page
G. Rossoni, M. Gomaraschi, F. Berti, C. R. Sirtori, G. Franceschini, and L. Calabresi
Synthetic High-Density Lipoproteins Exert Cardioprotective Effects in Myocardial Ischemia/Reperfusion Injury
J. Pharmacol. Exp. Ther., January 1, 2004; 308(1): 79 - 84.
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J. Biol. Chem.Home page
N. Wang, D. Lan, M. Gerbod-Giannone, P. Linsel-Nitschke, A. W. Jehle, W. Chen, L. O. Martinez, and A. R. Tall
ATP-binding Cassette Transporter A7 (ABCA7) Binds Apolipoprotein A-I and Mediates Cellular Phospholipid but Not Cholesterol Efflux
J. Biol. Chem., October 31, 2003; 278(44): 42906 - 42912.
[Abstract] [Full Text] [PDF]


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J. Biol. Chem.Home page
L. Liu, A. E. Bortnick, M. Nickel, P. Dhanasekaran, P. V. Subbaiah, S. Lund-Katz, G. H. Rothblat, and M. C. Phillips
Effects of Apolipoprotein A-I on ATP-binding Cassette Transporter A1-mediated Efflux of Macrophage Phospholipid and Cholesterol: FORMATION OF NASCENT HIGH DENSITY LIPOPROTEIN PARTICLES
J. Biol. Chem., October 31, 2003; 278(44): 42976 - 42984.
[Abstract] [Full Text] [PDF]


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J. Lipid Res.Home page
K. E. Schmid, W. S. Davidson, L. Myatt, and L. A. Woollett
Transport of cholesterol across a BeWo cell monolayer: implications for net transport of sterol from maternal to fetal circulation
J. Lipid Res., October 1, 2003; 44(10): 1909 - 1918.
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Arterioscler. Thromb. Vasc. Bio.Home page
O. L. Francone
SR-BI: A New Player in an Old Game
Arterioscler Thromb Vasc Biol, September 1, 2003; 23(9): 1486 - 1487.
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Arterioscler. Thromb. Vasc. Bio.Home page
A. R. Tall
ATVB In Focus: Role of ABCA1 in Cellular Cholesterol Efflux and Reverse Cholesterol Transport
Arterioscler Thromb Vasc Biol, May 1, 2003; 23(5): 710 - 711.
[Full Text] [PDF]