Interaction between HDL and inflammation: When the good turns to be bad

A translational evidence for cholesteryl ester transfer protein modulation by glucocorticoids: A time for reflection

“…14 Recently, evidences are increasing that the atheroprotective role of HDL turns to atherogenic in conditions of increased inflammatory burden. 15 Finally, in the recent REVEAL trial, the 9% lower rate of the primary outcome, for example first major coronary event, occurring in the anacetrapib group appeared to be mostly explained by lower levels of atherogenic lipoproteins, for example LDL-c, and not by higher HDL-c levels. 9 For all of these reasons, based on today robust data, the principle "lower low-density lipoprotein is better, and lowest is best" appears more convincing instead of "increasing HDL-c".…”

“…As a further proof of the absence of a direct relationship between HDL‐c and risk for CV disease, patients with a mutant form of apo A‐I, the so‐called apo A‐I Milano, carried low levels of HDL‐c and did not experience a higher risk for coronary heart disease . Recently, evidences are increasing that the atheroprotective role of HDL turns to atherogenic in conditions of increased inflammatory burden . Finally, in the recent REVEAL trial, the 9% lower rate of the primary outcome, for example first major coronary event, occurring in the anacetrapib group appeared to be mostly explained by lower levels of atherogenic lipoproteins, for example LDL‐c, and not by higher HDL‐c levels .…”