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高密度脂蛋白（HDL）在預防動脈粥樣硬化中的角色：不斷演變的概念

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最新研究揭示，高密度脂蛋白（HDL）在預防動脈粥樣硬化方面的作用不僅限於逆向膽固醇運輸。HDL能從周邊血管的脂質泡沫細胞中移除膽固醇並運送至肝臟排出。此外，HDL在凝血系統中展現多重益處，改善血小板功能，與蛋白質C和蛋白質S系統具有複雜交互作用，同時也提升纖溶平衡。HDL亦具有顯著的天然抗氧化作用，抑制低密度脂蛋白的氧化並增強內皮細胞功能。

高密度脂蛋白在防止動脈粥樣硬化方面的角色觀念的演變

Evolving concepts of the role of high-density lipoprotein in protection from atherosclerosis

John A Farmer 1, Joshua Liao
Affiliations expand
PMID: 21380938 DOI: 10.1007/s11883-011-0166-3

https://pubmed.ncbi.nlm.nih.gov/21380938/

Abstract

High-density lipoprotein (HDL) is classified as a negative risk factor due to the inverse relationship between elevated levels of HDL cholesterol and atherosclerosis. The mechanism by which HDL can mediate protection from atherosclerosis is complex and multifactorial. The primary role of reverse cholesterol transport in the reduction of risk for coronary artery disease is supported by a considerable amount of experimental data. HDL is able to interact with and remove cholesterol from the lipid-laden foam cells in the peripheral vasculature with subsequent transportation to the liver for excretion. However, HDL has multiple other physiologic effects that may play a significant role in protection from atherosclerosis. HDL has been demonstrated to exhibit multiple beneficial effects on the coagulation system. Platelet function is improved by both direct and indirect mechanisms. HDL has a complex interaction with the protein C and protein S system. Thrombolytic balance is also improved by HDL. HDL has been demonstrated to have a significant natural antioxidant effect that inhibits the oxidative step required for low-density lipoprotein uptake by the macrophage. Additionally, HDL has also been demonstrated to exert multiple beneficial effects on endothelial function, including decreased apoptosis and endothelial repair.

摘要

高密度脂蛋白（HDL）被分類為負面風險因素，這是由於HDL膽固醇水平的提高與動脈粥樣硬化之間存在反向關係。HDL介導防止動脈粥樣硬化的機制是複雜且多因素的。大量實驗數據支持逆向膽固醇運輸在降低冠狀動脈疾病風險中的主要作用。HDL能夠與周邊血管系統中的脂質負荷泡沫細胞發生相互作用，並從中去除膽固醇，隨後運輸至肝臟進行排泄。然而，HDL具有多種其他生理效應，這些效應可能在防止動脈粥樣硬化方面發揮重要作用。已證明HDL對凝血系統展現出多種有益效應。HDL通過直接和間接機制改善血小板功能。HDL與蛋白C和蛋白S系統有複雜的相互作用。HDL還改善了纖溶平衡。HDL已被證明具有顯著的天然抗氧化作用，這能抑制低密度脂蛋白被巨噬細胞攝取所需的氧化步驟。此外，已證明HDL還對內皮功能產生多種有益效應，包括減少細胞凋亡和促進內皮修復。

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