Pharmacological approaches to modifying HDL: more basic science to understand HDL metabolism is necessary. Editorial to: 'NO-1886 up-regulates Niemann-Pick C1 protein (NPC1) expression through liver X receptor alpha signaling pathway in THP-1 macrophage-derived foam cells' by Xin Ma et al.

摘要

While lowering LDL-C has well established benefits, modification of HDL by pharmacological therapy remains an elusive goal in demonstrating conclusive improvements in cardiovascular outcomes. Part of the challenge in developing therapeutic approaches to HDL is that it is unclear whether increasing HDL-C levels or modifying HDL function or increasing reverse cholesterol transport is (are) the mechanism(s) by which HDL protects against cardiovascular disease. In light of the spectacular failure of torcetrapib, a CETP inhibitor (with toxic off-target effects), it is prudent to better understand the means by which cells utilize HDL to efflux excess cholesterol.