In the past decade, high-density lipoproteins (HDL) have emergedas a new potential therapeutic target for the treatment of cardiovasculardisease. The key role of HDL as a carrier of excess cellularcholesterol in the reverse cholesterol transport pathway isbelieved to provide protection against atherosclerosis. In reversecholesterol transport, peripheral tissues (e.g., vessel-wallmacrophages) remove their excess cholesterol through the ATP-bindingcassette transporter 1 (ABCA1) to poorly lipidated apolipoproteinA-I, forming pre--HDL. Lecithincholesterol acyltransferasethen esterifies free cholesterol to cholesteryl esters, convertingpre--HDL to mature spherical -HDL (see Figure).
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From the National Heart, Lung, and Blood Institute, Bethesda, Md.
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