Rizzo M, Otvos J, Nikolic D, Montalto G, Toth P P, Banach M
Biomedical Department of Internal Medicine and Medical Specialties (DiBiMIS), University of Palermo, Via del Vespro, 141, 90127, Palermo, Italy.
Curr Med Chem. 2014;21(25):2881-91. doi: 10.2174/0929867321666140414103455.
High-density lipoproteins (HDL) are classified as atheroprotective because they are involved in transport of cholesterol to the liver, known as "reverse cholesterol transport (RCT)" exerting antioxidant and anti-inflammatory activities. There is also evidence for cytoprotective, vasodilatory, antithrombotic, and anti-infectious activities for these lipoproteins. HDLs are known by structural, metabolic and biologic heterogeneity. Thus, different methods are able to distinguish several subclasses of HDL. Different separation techniques appear to support different HDL fractions as being atheroprotective or related with lower cardiovascular (CV) risk. However, HDL particles are not always protective. Modification of constituents of HDL particles (primarily in proteins and lipids) can lead to the decrease in their activity and induce proatherogenic properties, especially when isolated from patients with augmented systemic inflammation. According to available studies, it seems that HDL functionality may be a better therapeutic target than HDL cholesterol quantity; however, it is still disputable which subfractions are most beneficial. There is mounting evidence supporting HDL subclasses as an important biomarker to predict and/or reduce CV risk. In this review we discuss recent notices on atheroprotective and functional characteristic of different HDL subfractions. Also, we provide a brief overview of the different methods used by clinicians and researchers to separate HDL subfractions. Ongoing and future investigations will yield important new information if any given separation method might represent a 'gold standard', and which subfractions are reliable markers of CV risk and/or potential targets of novel, more focused, and effective therapies.
高密度脂蛋白（HDL）被归类为具有抗动脉粥样硬化保护作用，因为它们参与将胆固醇转运至肝脏，即所谓的“逆向胆固醇转运（RCT）”，并具有抗氧化和抗炎活性。也有证据表明这些脂蛋白具有细胞保护、血管舒张、抗血栓形成和抗感染活性。HDL具有结构、代谢和生物学异质性。因此，不同方法能够区分HDL的几个亚类。不同的分离技术似乎支持不同的HDL组分具有抗动脉粥样硬化保护作用或与较低的心血管（CV）风险相关。然而，HDL颗粒并非总是具有保护作用。HDL颗粒成分的改变（主要是蛋白质和脂质方面）可导致其活性降低并诱导促动脉粥样硬化特性，尤其是从全身炎症增强的患者中分离出来时。根据现有研究，HDL功能可能比HDL胆固醇量是更好的治疗靶点；然而，哪种亚组分最有益仍存在争议。越来越多的证据支持HDL亚类作为预测和/或降低CV风险的重要生物标志物。在本综述中，我们讨论了不同HDL亚组分的抗动脉粥样硬化保护和功能特性的最新研究。此外，我们简要概述了临床医生和研究人员用于分离HDL亚组分的不同方法。如果任何给定的分离方法可能代表“金标准”，以及哪些亚组分是CV风险的可靠标志物和/或新型、更有针对性和更有效治疗的潜在靶点，正在进行的和未来的研究将产生重要的新信息。
