The composition of
high-density lipoprotein (HDL) changes during
inflammation; however, potential changes of HDL function during
inflammation and the effects of
acute phase proteins that are either on the HDL particles or in the serum have not been clarified. The concentrations of
C-reactive protein (CRP),
serum amyloid A protein (apoSAA)
isoforms,
lipids and
apolipoproteins, and the activities of
lecithin-cholesterol acyltransferase (LCAT) and
paraoxonase (PON) were measured before and after
laparoscopic cholecystectomy, in 12 patients with
cholecystolithiasis to clarify the function of acute-phase HDL and the relationship between
acute-phase proteins and HDL functions. Both acute-phase apoSAA (A-apoSAA) and CRP increased, reached their maximum levels 3-6 days after the operation, and then returned to preoperative levels after 2 weeks. In contrast,
apolipoproteins and LCAT decreased reciprocally, reached their minimum levels 3-6 days after the operation, and returned to preoperative levels after 2 weeks. However, PON decreased 3-6 days after the operation, and remained low even after 2 weeks. At the nadir the mean activities of LCAT and PON were 56 and 76% of the preoperative levels, respectively.
HDL-cholesterol or constitutive apoSAA did not change significantly. LCAT has been reported to be involved in reverse-
cholesterol transport and PON to be preventive for lipid peroxidation of
low-density lipoprotein in vitro. Thus, during the acute phase of
inflammation, HDL may be altered to an atherogenic state due to a decrease in LCAT and PON activities. Therefore, this longitudinal analysis was carried out to determine whether HDL function is modified in a single episode of
inflammation and thus may contribute to the occurrence of atherosclerotic disease in patients with chronic or recurrent acute
inflammation.