Journal of Lipid Research, Vol 31, 2295-2299, Copyright © 1990 by Lipid Research, Inc.
International Symposium on Reverse Cholesterol Transport. Report on a meeting
AG Lacko and PH Pritchard
Texas College of Osteopathic Medicine, University of North Texas.
The purpose of this symposium was to provide a forum for the reporting of
recent findings and the exchange of ideas concerning reverse cholesterol
transport, an area of intense interest and some controversy. Data from
epidemiological studies have consistently shown that elevated levels of
high density lipoproteins (HDL) are an index of increased protection
against coronary heart disease. However, the mechanism whereby HDL is
involved in the prevention and/or reversal of atherosclerosis is unknown.
According to one of the hypotheses, HDL acts as the primary acceptor of
unesterified cholesterol from cells and functions jointly with the enzyme
lecithin:cholesterol acyltransferase (LCAT) and the cholesteryl ester
transfer protein (CETP) to facilitate the movement of cholesterol from
peripheral tissues to the plasma and ultimately to the liver. Although this
mechanism as originally proposed by Glomset is an essential physiological
mechanism, the clinical significance of this hypothesis remains
unsubstantiated. Key elements of knowledge are lacking that would allow the
linking of cholesterol efflux from cells and tissues with specific events
in HDL metabolism, particularly those that are relevant to the prevention
and/or reversal of atherosclerosis. Because of the intricate nature of the
interaction between the components of reverse cholesterol transport, a
conference involving the leading investigators of the field, where
extensive discussion of the findings and ideas is allowed, appeared highly
desirable. Indeed, from the distance of nearly 4 months, feedback from the
participants indicates that the meeting was highly successful and the
organizers feel that all the projected goals of the symposium were
accomplished.
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