Abstract:
:Reduction of low-density lipoprotein-cholesterol through statin therapy has only modestly decreased coronary heart disease (CHD)-associated mortality in developed countries, which has prompted the search for alternative therapeutic strategies for CHD. Major efforts are now focused on therapies that augment high-density lipoprotein (HDL)-mediated reverse cholesterol transport (RCT), and ultimately increase the fecal disposal of cholesterol. The process of RCT has long been thought to simply involve HDL-mediated delivery of peripheral cholesterol to the liver for biliary excretion out of the body. However, recent studies have revealed a novel pathway for RCT that does not rely on biliary secretion. This non-biliary pathway rather involves the direct excretion of cholesterol by the proximal small intestine. Compared to RCT therapies that augment biliary sterol loss, modulation of non-biliary fecal sterol loss through the intestine is a much more attractive therapeutic strategy, given that excessive biliary cholesterol secretion can promote gallstone formation. However, we are at an early stage in understanding the molecular mechanisms regulating the non-biliary pathway for RCT, and much additional work is required in order to effectively target this pathway for CHD prevention. The purpose of this review is to discuss our current understanding of biliary and non-biliary contributions to RCT with particular emphasis on the possibility of targeting the intestine as an inducible cholesterol secretory organ.
journal_name
World J Gastroenteroljournal_title
World journal of gastroenterologyauthors
Temel RE,Brown JMdoi
10.3748/wjg.v16.i47.5946subject
Has Abstractpub_date
2010-12-21 00:00:00pages
5946-52issue
47eissn
1007-9327issn
2219-2840journal_volume
16pub_type
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pub_type: 杂志文章,meta分析,评审
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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doi:10.3748/wjg.v12.i13.2130
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journal_title:World journal of gastroenterology
pub_type: 杂志文章,评审
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更新日期:2007-08-28 00:00:00
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journal_title:World journal of gastroenterology
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doi:10.3748/wjg.v13.i3.408
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pub_type: 杂志文章
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pub_type: 杂志文章
doi:10.3748/wjg.v9.i1.50
更新日期:2003-01-01 00:00:00
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pub_type: 杂志文章
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journal_title:World journal of gastroenterology
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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更新日期:2003-11-01 00:00:00
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journal_title:World journal of gastroenterology
pub_type: 杂志文章
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journal_title:World journal of gastroenterology
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更新日期:2003-04-01 00:00:00
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pub_type: 杂志文章
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更新日期:2005-09-21 00:00:00
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更新日期:2004-02-15 00:00:00