Quality over Quantity: A Case Based Review of HDL Function and Dysfunction

Abstract

• Page 1 of 7 • Suleiman et al. Int J Clin Cardiol 2020, 7:176 Citation: Suleiman S, Coughlan JJ, Maher V (2020) Quality over Quantity: A Case Based Review of HDL Function and Dysfunction. Int J Clin Cardiol 7:176. doi.org/10.23937/2378-2951/1410176 Accepted: May 14, 2020; Published: May 16, 2020 Copyright: © 2020 Suleiman S, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. A large number of proteins involved in inflammation, complement regulation, and innate immunity are physiologically bound to HDL [5]. These reinforce the concept that HDL evolved as a component of the innate immune system and is reflected in its pleiotropic functions in the body [6]. With its constant remodeling via enzymes and tissues, various subclasses, structural diversity, interactions, and functionality, HDL has a larger role in health and disease [7]. This inverse correlation between raised levels of HDL and ASCVD is not necessarily causal [8] and numerous studies have failed to show reduced ASCVD risk with elevation of HDL [9-11]. Contemporary data has highlighted that higher levels of HDL may be detrimental to cardio-vascular health, demonstrating a unique U-shape association between raised HDL and ASCVD risk [12] in men. This paradoxical rise in ASCVD risk is likely driven by several reasons including genetic mutation, the concept of HDL dysfunction and inflammation. This had led to an increasing interest in quantifying HDL function and though the reverse cholesterol transport process (RCT) has been given primacy with regard to the proposed mechanistic relationship between HDL and ASCVD, HDL also demonstrates anti-inflammatory, anti-apoptotic, anti-oxidative and vaso-protective properties [13-16].