Abstract
Lipoproteins were initially defined according to their composition (lipids and proteins) and classified according to their density (from very low- to high-density lipoproteins—HDLs). Whereas their capacity to transport hydrophobic lipids in a hydrophilic environment (plasma) is not questionable, their primitive function of cholesterol transporter could be challenged. All lipoproteins are reported to bind and potentially neutralize bacterial lipopolysaccharides (LPS); this is particularly true for HDL particles. In addition, HDL levels are drastically decreased under infectious conditions such as sepsis, suggesting a potential role in the clearance of bacterial material and, particularly, LPS. Moreover, "omics" technologies have unveiled significant changes in HDL composition in different inflammatory states, ranging from acute inflammation occurring during septic shock to low-grade inflammation associated with moderate endotoxemia such as periodontal disease or obesity. In this review, we will discuss HDL modifications associated with exposure to pathogens including bacteria, viruses and parasites, with a special focus on sepsis and the potential of HDL therapy in this context. Low-grade inflammation associated with atherosclerosis, periodontitis or metabolic syndrome may also highlight the protective role of HDLs in theses pathologies by other mechanisms than the reverse transport of cholesterol.
Highlights
High-density lipoproteins (HDLs) are regarded as cholesterol transporters in charge of reverse cholesterol transport from tissues back to the liver
We will discuss HDL modifications associated with exposure to pathogens including bacteria, viruses and parasites, with a special focus on sepsis and the potential of HDL therapy in this context
HDL-C-raising therapies all failed at improving cardiovascular outcome, such as cholesteryl ester-transfer protein (CETP) inhibitors, which were very disappointing in phase III trials, for which the conclusion was “insufficient cardiovascular benefit for routine use” [2]
Summary
High-density lipoproteins (HDLs) are regarded as cholesterol transporters in charge of reverse cholesterol transport from tissues back to the liver. They are associated with reduced risk of developing cardiovascular clinical complications, notably since the publication of the Framingham study, concluding that low HDL-cholesterol (HDL-C) levels were as much a risk factor for coronary artery disease (CAD) as high LDL-C [1]. Recent Mendelian studies challenged the causal role of low HDL-C levels in cardiovascular diseases (CVD) [5]. In this context, HDL research in CVD resulted less attractive and is currently somehow abandoned.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
