McMahon M, Grossman J, Skaggs B et al. Arthritis Rheum 2009;60:2428–37.
High-density lipoproteins (HDL) are not always “the good cholesterol”. In the setting of inflammation, HDL may become pro-atherogenic. In this study, the authors confirm that pro-inflammatory HDL (piHDL) is common in systemic lupus erythematosus and find that it represents a powerful independent risk factor for subclinical atherosclerosis.
In the healthy individual, high-density lipoproteins (HDL) help transport excess cholesterol to the liver as well as maintaining low-density lipoprotein cholesterol in a non-oxidated, and thus less atherogenic, state, among other beneficial properties. However, under inflammatory conditions, the surface proteins of HDL may change, resulting in a pro-inflammatory and even pro-atherogenic state.