High-density lipoprotein: does it have a dark side?

Understanding Accelerated Atherosclerosis in Systemic Lupus Erythematosus: Toward Better Treatment and Prevention

Systemic lupus erythematosus (SLE) carries a significant risk of cardiovascular disease (CVD). The prevalence of premature CVD is especially noteworthy because it occurs in premenopausal women with SLE who would otherwise have very low rates of CVD. While traditional risk factors likely play a role in development of CVD in the setting of SLE, they do not fully explain the excess risk. The pathogenesis of CVD in SLE is not fully understood, but the inflammatory nature of SLE is believed to be a key factor in accelerating atherosclerosis. Systemic inflammation may lead to an abnormal lipid profile with elevated triglycerides, total cholesterol, and low-density lipoprotein cholesterol and dysfunctional high-density lipoprotein cholesterol. Additionally, the inflammatory milieu of SLE plasma promotes endothelial dysfunction and vascular injury, early steps in the progression of atherosclerotic CVD. Despite the overall headway that has been achieved in treating lupus, innovative therapeutics specifically targeting the progression of atherosclerosis within the lupus population are currently lacking. However, there have been advancements in the development of promising modalities for diagnosis of subclinical atherosclerosis and detection of high CVD risk patients. Due to the significant impact of CVD on morbidity and mortality, research addressing prevention and treatment of CVD in SLE needs to be prioritized. This review explores the intricate interplay of SLE-specific properties that contribute to atherosclerosis and CVD within this population, as well as screening methods and possible therapies.

Human induced pluripotent stem cell‑derived mesenchymal stem cells alleviate atherosclerosis by modulating inflammatory responses

The transplantation of mesenchymal stem cells (MSCs) has been a reported method for alleviating atherosclerosis (AS). Because the availability of bone marrow‑derived MSCs (BM‑MSCs) is limited, the authors used this study to explore the use of a new type of MSC, human induced pluripotent stem cell‑derived MSCs (iPSC‑MSCs), to evaluate whether these cells could alleviate AS. iPSC‑MSCs were intravenously administered to ApoE knock out mice fed on a high‑fat diet (HFD) for 12 weeks. It was reported that systematically administering iPSC‑MSCs clearly reduced the size of plaques. In addition, the numbers of macrophages and lipids in plaques were lower in the HFD + iPSC‑MSCs group than in the HFD group. Furthermore, iPSC‑MSCs attenuated AS‑associated inflammation by decreasing the levels of inflammatory cytokines, such as tumor necrosis factor‑α and interleukin‑6, in serum. In addition, the expression of Notch1 was higher in the HFD group, and injecting iPSC‑MSCs reversed this effect. In conclusion, the current study provides the first evidence indicating that iPSC‑MSCs may be a new optional MSC‑based strategy for treating AS.