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High-density lipoprotein and ApoA1-Milano – Full circle from bench to bedside

The first presentation in this session was given by D. Ibanez from Madrid, Spain. He showed very elegantly that recombinant Apo AI Milano administration in rabbits resulted in reverse-cholesterol-transport enhancement after 4 days. Even more, it induced a “rescue” from global inflammatory status associated with atherosclerosis. According to the results of this study the Milano form of apo-AI seems to be more efficient in reverse-cholesterol-transport than the apo AI wild type.


The second presentation was given by the same author. In this second study, rabbits were exposed to apo AI Milano, which stabilized the atherosclerotic lesions. However, 6 months later, the acute effect on atherosclerotic plaque volume was still maintained and cholesterol content in plaques from animals receiving apo AI Milano was still significantly lower than in the placebo group. Even the protein expression at the artery wall revealed a lower inflammatory status 6 months after the treatment.

V. Petoumenos from Bonn, Germany presented very interesting results of a study looking into the effects of HDL on endothelial progenitor cells (EPC).  The results of the study indicate that HDL has an important effect on number and function of EPC in humans inhibiting EPC apoptosis, enhancing the migratory capacity and improving homing of circulating cells by influencing adhesion possibility due to an up-regulation of CD49d.

J. Johansson from Calgary, Canada showed the first data about a novel small molecule called RVX-208.Oral administration of this substance increases production of apo AI in rodents and some other animals. In healthy volunteers, it was safe at exposure levels shown to increase apo AI production but did not significantly increase HDL-cholesterol.

R Waxman from Washington DC, USA reported on a first-in-man, randomized, placebo-controlled study with autologous delipidated HDL plasma infusions in patients with acute coronary syndrome. Such a treatment was well tolerated, a numeric trend towards reduction in atheroma volume could be seen but, most probably due to a small number of participants, no significant changes in IVUS parameters could be proven.

B. Arsenault from Amsterdam, Netherlands showed results of a prospective case-control study nested in the EPIC-Norfolk cohort on 1035 apparently healthy persons who developed CHD matched to 1920 control subjects. The results indicate that a decreased HDL particle size is associated with an increased CHD risk. However, after controlling for markers of the atherogenic dyslipidemia of the metabolic syndrome such as HDL cholesterol, this association was no longer observed.




High-density lipoprotein and ApoA1-Milano – Full circle from bench to bedside

Notes to editor

This congress report accompanies a presentation given at the ESC Congress 2008. Written by the author himself/herself, this report does not necessarily reflect the opinion of the European Society of Cardiology.

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.