Key result
Chronic systemic inflammation transforms HDL into a pro-atherosclerotic lipoprotein, limiting the benefit of increasing HDL.
Why the study?
Chronic inflammation alters the HDL proteome and lipidome from atheroprotective to pro-atherosclerotic, explaining why simply increasing HDL concentration in patients with inflammatory diseases has failed to yield anti-atherogenic benefits.
This review highlights that chronic inflammation alters the HDL proteome to a pro-atherosclerotic state, explaining why simply raising HDL levels may not yield anti-atherogenic benefits in these patients.
Answers are grounded in this paper and cite their sources.
HDL-raising may lack benefit in chronic inflammation; leaves open proteome-targeted interventions for trials.
Chronic inflammatory diseases, such as rheumatoid arthritis, steatohepatitis, periodontitis, chronic kidney disease, and others are associated with an increased risk of atherosclerotic cardiovascular disease, which persists even after accounting for traditional cardiac risk factors. The common factor linking these diseases to accelerated atherosclerosis is chronic systemic low-grade inflammation triggering changes in lipoprotein structure and metabolism. HDL, an independent marker of cardiovascular risk, is a lipoprotein particle with numerous important anti-atherogenic properties. Besides the essential role in reverse cholesterol transport, HDL possesses antioxidative, anti-inflammatory, antiapoptotic, and antithrombotic properties. Inflammation and inflammation-associated pathologies can cause modifications in HDL's proteome and lipidome, transforming HDL from atheroprotective into a pro-atherosclerotic lipoprotein. Therefore, a simple increase in HDL concentration in patients with inflammatory diseases has not led to the desired anti-atherogenic outcome. In this review, the functions of individual protein components of HDL, rendering them either anti-inflammatory or pro-inflammatory are described in detail. Alterations of HDL proteome (such as replacing atheroprotective proteins by pro-inflammatory proteins, or posttranslational modifications) in patients with chronic inflammatory diseases and their impact on cardiovascular health are discussed. Finally, molecular, and clinical aspects of HDL-targeted therapies, including those used in therapeutical practice, drugs in clinical trials, and experimental drugs are comprehensively summarised.
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Vyletelová et al. (2022) conducted a review in Chronic inflammatory diseases and atherosclerotic cardiovascular disease. HDL-targeted therapies was evaluated. Chronic systemic inflammation transforms HDL from an atheroprotective into a pro-atherosclerotic lipoprotein by altering its proteome, limiting the efficacy of simply increasing HDL concentration.
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