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Effects of inflammation on high-density lipoproteins.

High-density lipoproteins (HDLs) protect against the development of atherosclerotic coronary heart disease.1 In part, this reflects the ability of HDL to promote the efflux of cholesterol from macrophages in the artery wall2 but given that atherosclerosis is an inflammatory disorder,3 it may also reflect anti-inflammatory properties of HDL.4,5⇓ Conversely, inflammation reduces the concentration of HDL and possibly compromises the anti-atherogenic functions of these lipoproteins.6 Given the pathophysiological implications of a potentially detrimental effect of inflammation on HDL function, it is clearly important to understand the mechanisms that may be involved. Such mechanisms are the subject of an article by Tietge et al7 in this issue of Arteriosclerosis, Thrombosis, and Vascular Biology .

See page 1213 

These authors provide compelling evidence that the effects of inflammation on HDL are the result mainly of activity of secretory phospholipase A2 (sPLA2), an acute phase reactant that is known to be present at increased concentration in plasma in a variety of inflammatory states and which has the ability to remodel HDL.8 Because remodeling of HDL by a variety of plasma factors is known to play a major role in regulating the concentration and subpopulation distribution of HDL, the possibility that inflammation may have an impact on this remodeling is of potentially great importance.

Remodeling of HDL in plasma plays a major …