Statins reduce further deposition of lipid and in some cases with very high dose statin, some marginal reduction in atheroma may be seen.
In patients with substantial atheroma, one wants appreciable reversal and removal of lipid. Statins cannot do this
Initial studies with HDL infusions have shown promising results, but problems exist with immunogenicity .
Can HDL be rendered less immunogenic and is it a potential game changer in the world of cardiovascular disease and death?
Can we one day 'clean out' the atheroma from our arteries with this intervention?
I don't think so. Trials on drugs that raise HDL didn't show a significant benefit.
Thanks for the view, Mustafa Alshaikha
The trials on raising HDL by blocking CETP were a dismal failure, I agree.
But this mechanism is different?
Article HDL Infusion Therapy and Atherosclerosis: Current Research a...
Article HDL Mimetics Infusion and Regression of Atherosclerosis: Is ...
https://www.acc.org/latest-in-cardiology/clinical-trials/2014/08/04/13/01/chi-square
Studies appear to be neutral.
Just seeing what opinions are out there...
A very interesting question Faz
Theoretically YES it MUST raise the good cholesterol
The pubmed research i found is as under:
Article Recent clinical trials evaluating benefit of drug therapy fo...
conclusion: "Pharmacological manipulation of HDL-C has not improved the cardiovascular outcomes. Several agents have caused harm or unacceptable side-effects"
Article Influence of HDL-cholesterol-elevating drugs on the in vitro...
This study inhibited HDL receptors, so resulted in increased HDL in return. These receptors were scavenger receptor class B type I (SR-BI)] activity.
Conclusion: "However, similarities of HDL376 treatment and SR-BI gene knockout on HDL metabolism in vivo (increased HDL-cholesterol and HDL particle sizes) and structure-activity relationship analysis suggest that SR-BI may be a target of HDL376 in vivo"
Article Cholesteryl ester transfer-protein modulator and inhibitors ...
However increasing HDL by other methods like CETP inhibition raised HDL and were found to be beneficial
So the research is probably ongoing but it seem that simply infusing HDL may not be beneficial.
Regards
Depends on whom you read. The matter of raising HDL-cholesterol and regression of atherothrombotic plaques is really a matter of how one raises HDL-cholesterol. Some methods are useful, while others are not. Stay tuned.
The point is not just raising HDL, but the efficacy of the oxLDL uptake at the site of atheroma and removal by the liver. That blocking CETP didn't work was logical from this point of view Just putting more garbage collecting trucks on the road while not improving the uptake at home nor delivery at the destruction site just creates traffic jams.
This was most clearly addressed in the apo-I Milano study where a population was found with extremely low HDL levels and still no atherosclerosis. So, better understanding of the reverse LDL transport system is of uttermost importance.
I have maintained that it makes a difference how one raises HDL-cholsterol. In both POSCH and the NHLB I Tye II Secondary Prevention trial the gut microbiome was bypassed by suregery (POSCH) and by resin use (NHLB I). I suggested that this might decrease TMAO production in the gut and TMAO is known to block reverse cholesterol transport. Any Comments?
Yes because of HDL_C has antioxidant abilityso it stables thrombosis by previnting LDL_C from oxidation in addition to its function in carrying cholesterol from cells to liver
I agree with the comments above, in addition trying to handling the atherosclerosis with HDL is like trying to fill a perforated pot with water. I think PCSK9 inhibitors are very promising and as you may appreciate the radical treatment is to go the gene level. Besides it's very hard to manipulate a plaque that has already formed.
A wonderful hidden tale of modern medical science. Epidemiologists observed an Association of HDL with cleaner arteries. Now every researcher first cautions us not to confuse Association with Causality - and then, after repeated references to the relationship, proceeds to do exactly that. The artery cleansing function of HDL is an unproved Hypothesis and, despite efforts to find actual Mechanisms of action, remains unproven.
This unmerited move from Association to Causality drives today’s cardiology. Why the Association of higher HDL with cleaner arteries? High carb diets (aided and abetted by fructose in sugar and corn syrup) cause de novo lipogenesis in the liver which produces VLDLs, which, crucially, interact with CETP in the blood to produce small, dense LDLs - and decrease HDL. As is widely recognized among heart disease researchers, these small dense LDLs penetrate arterial endothelium, setting off immune reactions which cause arterial plaque.
So HDL is just a marker; it’s the VLDLs (measured as triglycerides) that are worthy of your attention. They will plunge on a very-low-carb diet.
Forum Post: “On this type of diet I have dropped 60 pounds, dropped by cholesterol 100 points, moved my LDL to "big and fluffy", raised my HDL, crashed my triglycerides to 60, .... PS I am a physician with a degree in nutrition......everything I used to believe is wrong!”
TG are not found in plaques, but high TG are associated with low HDL. When TG levels fall, HDL levels usually rise. High HDL levels can protect against elevated (though not excessively elevated) LDL. This is why I use the ratio between LDL and HDL. Come to the NLA symposium in Miami next May and see for yourself.
Its not the quantity but the quality of HDL-C matters. It has been reported that reduced levels of large HDL (HDL2b) are strongly predictive of increased CHD risk, but smaller HDL subspecies are also of importance. Increases in specific smaller HDL subspecies (e.g. HDL3b) are a marker of atherogenic dyslipidemia. Like wise one may thought.......
Lipoproteins such as HDL are a series of lipid metabolism. If you give HDL infusion alone, it's certainly useless because the main problem maybe in primary or secundary dyslipidemia.
Dans la mesure ou il existerait une action que vous projetez .
quelle quantités vous allez perfusez,?
et si votre perfusion n est pas pure ,il y aurait forcement d autres réactions multiples.
,?????
Actually, the problem is base on how to increase the HDL naturally, which component of HDL to be increase, which component of HDL was effectiveness? Before any problem above was solved, how can we concluded that HDL effectivenss in their function?
I think if we infuse HDL rich in app A 1 fraction may reverse the atherosclerosis as it's the most important component of HDL playing a key told in reverse cholesterol transport and antioxidants