Impact of Systemic Inflammation and Autoimmune Diseases on apoA-I and HDL Plasma Levels and Functions

Abstract

The cholesterol of high-density lipoproteins (HDLs) and its major proteic component, apoA-I, have been widely investigated as potential predictors of acute cardiovascular (CV) events. In particular, HDL cholesterol levels were shown to be inversely and independently associated with the risk of acute CV diseases in different patient populations, including autoimmune and chronic inflammatory disorders. Some relevant and direct anti-inflammatory activities of HDL have been also recently identified targeting both immune and vascular cell subsets. These studies recently highlighted the improvement of HDL function (instead of circulating levels) as a promising treatment strategy to reduce inflammation and associated CV risk in several diseases, such as systemic lupus erythematosus and rheumatoid arthritis. In these diseases, anti-inflammatory treatments targeting HDL function might improve both disease activity and CV risk. In this narrative review, we will focus on the pathophysiological relevance of HDL and apoA-I levels/functions in different acute and chronic inflammatory pathophysiological conditions.

Associations between disease activity, markers of HDL functionality and arterial stiffness in patients with rheumatoid arthritis

“…There is a growing body of evidence that both acute and chronic inflammatory conditions induce compositional and functional modifications of apo A-I and HDL [39,40]. In our study, PON 1 activity (measured either as arylesterase or paraoxonase activity) was used as a surrogate marker of HDL antioxidative capacity similarly to other reports [41,42].…”

Diagnostic performance of a seven-marker serum protein biosignature for the diagnosis of active TB disease in African primary healthcare clinic attendees with signs and symptoms suggestive of TB

“…ApoA-1 is one of the most important biomarkers for cardiovascular disease,31 but is rarely investigated as a biomarker in TB. Like the other markers investigated in this study, ApoA-1 may not play any specific role in the pathogenesis of TB.…”

“…Like the other markers investigated in this study, ApoA-1 may not play any specific role in the pathogenesis of TB. The low levels obtained in patients with TB may be a result of the many changes in lipid metabolism, which are believed to occur after the generation of the acute-phase response following an inflammatory condition 31. One of the ways that CFH recognises host cells is by binding to host markers expressed on the surfaces of cells undergoing apoptosis 32.…”

Vascular inflammation and low‐density lipoproteins: is cholesterol the link? A lesson from the clinical trials

“…Chronic inflammatory diseases (such as RA or systemic lupus erythematosus) are associated with increased CV risk (Haque et al , ) and patients present with quantitatively and qualitatively altered lipid and lipoproteins profile that include a reduction of total cholesterol, HDL‐C and apolipoprotein A‐I, and increased levels of small dense LDL, lipoprotein(a) [Lp(a)] and triglycerides (TG) (de Carvalho et al , ; Amezaga Urruela and Suarez‐Almazor, ; Ammirati et al , ; Montecucco et al , ). A more severe disease state is associated with more pronounced alterations in lipids and lipoproteins profile.…”