CETP and Atherosclerosis

ver since cholesteryl ester transfer protein (CETP) was first identified, there have been conflicting opinions regarding its role (if any) in the development of atherosclerosis.According to 1 view, CETP is antiatherogenic by virtue of its ability to increase the rate of reverse cholesterol transport (RCT), the pathway in which cholesterol in peripheral tissues is transported to the liver for elimination in bile.This pathway involves an initial uptake of cell cholesterol by HDL, where it is esterified before being transferred by CETP to LDL and VLDL.The cholesteryl esters in the VLDL/LDL pool are subsequently delivered to the liver and ultimately eliminated from the body as a component of bile.Thus, to the extent that CETP enhances the rate of RCT, it may be an antiatherogenic factor.However, the fact that CETP redistributes cholesteryl esters from the nonatherogenic HDL to the potentially atherogenic VLDL/LDL implies that it may also be proatherogenic.