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Reverse cholesterol transport in familial hypercholesterolemia

机译：家族性高胆固醇血症中胆固醇的逆向转运

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Purpose of Review: Familial hypercholesterolemia is characterized by a major elevation in circulating LDL-cholesterol levels, cholesterol deposition within the arterial wall and an increased risk of premature coronary artery disease. The reverse cholesterol transport (RCT) is now considered as a key process that protects against development of atherosclerosis. The major antiatherogenic action of HDL particles is intimately linked to their determinant role in RCT pathway. However, the steady-sate of HDL-cholesterol levels does not represent the optimal marker to evaluate the efficiency of the RCT in all circumstances. Recent Findings: By using ex-vivo systems for the evaluation of the efficacy of RCT a strong inverse relationship between HDL efflux capacity from macrophages and atherosclerosis progression has been demonstrated. Low HDL-C phenotype observed in familial hypercholesterolemia patients is associated with defective capacities of HDL particles to mediate major steps of the centripetal movement of cholesterol from peripheral cells to feces. However, current available treatment used to reduce LDL-C to therapeutic goals does not correct altered functions of HDL particles in humans. Summary: In the context of familial hypercholesterolemia, a growing body of evidence suggests that impaired efficacy of the RCT pathway contributes significantly to the progression of atherosclerosis.
机译：审查目的：家族性高胆固醇血症的特征在于循环中的LDL-胆固醇水平显着升高，胆固醇在动脉壁内沉积以及早发冠状动脉疾病的风险增加。胆固醇逆向转运（RCT）现在被认为是预防动脉粥样硬化发展的关键过程。 HDL颗粒的主要抗动脉粥样硬化作用与其在RCT途径中的决定性作用密切相关。但是，HDL-胆固醇水平的稳定状态并不代表在所有情况下评估RCT效率的最佳指标。最新发现：通过使用离体系统评估RCT的有效性，已证明巨噬细胞的HDL外排能力与动脉粥样硬化进展之间存在强烈的反比关系。在家族性高胆固醇血症患者中观察到的低HDL-C表型与HDL颗粒介导胆固醇从周围细胞向粪便向心运动的主要步骤的缺陷能力有关。但是，当前用于将LDL-C降低至治疗目标的现有治疗方法无法纠正人类中HDL颗粒功能的改变。简介：在家族性高胆固醇血症的背景下，越来越多的证据表明，RCT途径的功效受损对动脉粥样硬化的进展有重要贡献。

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