Reverse cholesterol transport : a potential therapeutic target for atherosclerosis

Abstract

Atherosclerosis is the major cause of death in the Western society due to the development of acute clinical events such as myocardial infarction and cerebral stroke. Currently, lowering plasma LDL cholesterol (LDL-C) levels using statins, inhibitors of de-novo cholesterol synthesis, is the main therapeutic strategy to prevent the progression of atherosclerosis. The remaining high incidence of cardiovascular disease indicates a clear need for new therapies. Numerous epidemiological studies have established HDL cholesterol (HDL-C) levels as an inverse predictor for atherosclerosis. HDL has important anti-oxidative and anti-inflammatory properties. The most important atheroprotective function of HDL is, however, facilitation of reverse cholesterol transport (RCT), a process in which HDL removes excess cholesterol from peripheral tissues and subsequently delivers it to the liver for biliary excretion. In this thesis, the importance of RCT for prevention of atherosclerosis and the potential of RCT augmentation for the treatment of atherosclerosis were evaluated.