Preclinical studies have shown benefit of apolipoprotein A-I (apoA-I)/high-density lipoprotein (HDL) raising in atherosclerosis; however, this has not yet translated into a successful clinical therapy. Our studies demonstrate that apoA-I raising is more effective at reducing early-stage atherosclerosis than late-stage disease, indicating that the timing of HDL raising is a critical factor in its atheroprotective effects. To date, HDL-raising clinical trials have only been performed in aged patients with advanced atherosclerotic disease. Our findings therefore provide insight, related to important temporal aspects of HDL raising, as to why the clinical trials have thus far been largely neutral.
Keywords: Bcl-xL, B-cell lymphoma-extra large; HCAEC, human coronary artery endothelial cell; HDL, high-density lipoprotein; HFD, high-fat diet; LDL, low-density lipoprotein; LVApoAI, lentivirus overexpressing apolipoprotein A-I; LVGFP, lentivirus overexpressing green fluorescence protein; MCP, monocyte chemoattractant protein; SAA, serum amyloid amylase; SMC, smooth muscle cell; SNP, single-nucleotide polymorphism; TNF, tumor necrosis factor; VCAM, vascular cell adhesion molecule; apoA-I, apolipoprotein A-I; apoE−/−, apolipoprotein E deficient; atherosclerosis; cholesterol; high-density lipoproteins; micro-CT, micro-computed tomography; rHDL, reconstituted high-density lipoprotein.