Rader - Figure 3 - Efflux capacity questions Text

Macrophages need to rid themselves of cholesterol very actively, of course, because they take a lot in, and any given person’s HDL system appears to have a uniquely integrated ability to promote this cholesterol efflux from macrophages. As listed in the Figure, this leads to several questions:

• Do people differ in their ability to promote cholesterol efflux from macrophages?
• Is this a stable trait over time in individuals?
• Are there certain variables that predict efflux capacity in individuals, and can quantitation of this cholesterol efflux capacity serve as a measure of CVD risk, independent of the level of HDL cholesterol or apoA-I concentration in the blood?
• Are there genetic variants that correlate with these differences?
• Can efflux capacity actually predict atherosclerotic vascular disease?

A final question that is beyond the scope of this review is whether certain types of pharmacologic therapy might be able to promote cholesterol efflux.

Rader D. J Clin Lipidol. 2011; 5(6).