Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Comment
  • Published:

Size matters: HDL particle populations and the risk of infection

Low plasma levels of HDL cholesterol are a risk factor for infection and hospitalization for infectious disease. Recent work suggests that inadequate levels of HDL particles of specific sizes — small and medium — account for this risk. In this Comment, we discuss the mechanistic implications of these observations and the methodologies used to quantify HDL size.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Fig. 1: HDL size and macrophage function.

References

  1. Tall, A. R. & Yvan-Charvet, L. Cholesterol, inflammation and innate immunity. Nat. Rev. Immunol. 15, 104–116 (2015).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  2. Sorci-Thomas, M. G. & Thomas, M. J. Microdomains, inflammation, and atherosclerosis. Circ. Res. 118, 679–691 (2016).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. Rosenson, R. S. et al. HDL measures, particle heterogeneity, proposed nomenclature, and relation to atherosclerotic cardiovascular events. Clin. Chem. 57, 392–410 (2011).

    Article  CAS  PubMed  Google Scholar 

  4. Trinder, M., Walley, K. R., Boyd, J. H. & Brunham, L. R. Causal inference for genetically determined levels of high-density lipoprotein cholesterol and risk of infectious disease. Arterioscler. Thromb. Vasc. Biol. 40, 267–278 (2020).

    Article  CAS  PubMed  Google Scholar 

  5. Harsløf, M., Pedersen, K. M., Afzal, S., Smith, G. D. & Nordestgaard, B. G. Lower levels of small HDL particles associated with increased infectious disease morbidity and mortality: a population-based cohort study of 30 195 individuals. Cardiovasc. Res. https://doi.org/10.1093/cvr/cvac194 (2022).

    Article  PubMed  Google Scholar 

  6. Ala-Korpela, M., Zhao, S., Järvelin, M. R., Mäkinen, V. P. & Ohukainen, P. Apt interpretation of comprehensive lipoprotein data in large-scale epidemiology: disclosure of fundamental structural and metabolic relationships. Int. J. Epidemiol. 51, 996–1011 (2022).

    Article  PubMed  Google Scholar 

  7. He, Y. et al. Diabetes impairs cellular cholesterol efflux from ABCA1 to small HDL particles. Circ. Res. 127, 1198–1210 (2020).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Rader, D. J. Molecular regulation of HDL metabolism and function: implications for novel therapies. J. Clin. Invest. 116, 3090–3100 (2006).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Huang, R. et al. Apolipoprotein A-I structural organization in high-density lipoproteins isolated from human plasma. Nat. Struct. Mol. Biol. 18, 416–422 (2011).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Hutchins, P. M. et al. Quantification of HDL particle concentration by calibrated ion mobility analysis. Clin. Chem. 60, 1393–1401 (2014).

    Article  CAS  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Jay W. Heinecke.

Ethics declarations

Competing interests

The authors declare no competing interests.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Heinecke, J.W., Davidson, W.S. Size matters: HDL particle populations and the risk of infection. Nat Rev Cardiol 20, 279–280 (2023). https://doi.org/10.1038/s41569-023-00844-8

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41569-023-00844-8

Search

Quick links

Nature Briefing: Translational Research

Sign up for the Nature Briefing: Translational Research newsletter — top stories in biotechnology, drug discovery and pharma.

Get what matters in translational research, free to your inbox weekly. Sign up for Nature Briefing: Translational Research