A new model of reverse cholesterol transport: enTICEing strategies to stimulate intestinal cholesterol excretion

Trends Pharmacol Sci. 2015 Jul;36(7):440-51. doi: 10.1016/j.tips.2015.04.002. Epub 2015 Apr 27.

Abstract

Cardiovascular disease (CVD) remains the largest cause of mortality in most developed countries. Although recent failed clinical trials and Mendelian randomization studies have called into question the high-density lipoprotein (HDL) hypothesis, it remains well accepted that stimulating the process of reverse cholesterol transport (RCT) can prevent or even regress atherosclerosis. The prevailing model for RCT is that cholesterol from the artery wall must be delivered to the liver where it is secreted into bile before leaving the body through fecal excretion. However, many studies have demonstrated that RCT can proceed through a non-biliary pathway known as transintestinal cholesterol excretion (TICE). The goal of this review is to discuss the current state of knowledge of the TICE pathway, with emphasis on points of therapeutic intervention.

Keywords: bile; cholesterol; lipoprotein; reverse cholesterol transport; transintestinal cholesterol excretion.

Publication types

  • Research Support, N.I.H., Extramural
  • Review

MeSH terms

  • Bile / metabolism*
  • Biliary Tract / metabolism*
  • Biological Transport
  • Cardiovascular Diseases / metabolism*
  • Cholesterol / metabolism*
  • Cholesterol, HDL / metabolism
  • Feces / chemistry
  • Humans
  • Intestinal Mucosa / metabolism*
  • Liver / metabolism
  • Models, Biological*

Substances

  • Cholesterol, HDL
  • Cholesterol