HDL cholesterol: atherosclerosis and beyond

Cardiovascular disease (CVD) is the leading cause of death in the Western world. Myocardial infarction and stroke are the result of a compromised blood flow which may result from cholesterol accumulation in the vessel wall due to high plasma levels of LDL cholesterol. High plasma levels of HDL cholesterol, however, are inversely associated with CVD. This is commonly ascribed to a concept called "reverse cholesterol transport" a mechanism by which the HDL particle takes up cholesterol from the vessel wall for subsequent clearance by the liver. Therefore, increasing HDL cholesterol may decrease atherosclerosis and reduce cardiovascular disease. In the first part of this thesis, we aimed to unravel the relationship between HDL cholesterol and atherosclerosis.
Furthermore, HDL cholesterol exerts effects beyond the vessel wall. In the second part of this thesis, we investigated the effects of cholesterol on hormone synthesis, hematopoiesis and inflammation. This advances our understanding of human physiology and aids the prediction of the effects of HDL cholesterol increasing therapies.