HDL biology
A review credits probucol as the only drug shown to directly raise CETP activity and mass, potentially aiding cholesterol removal from tissues (Atherosclerosis 1991)
Original title: Reverse cholesterol transport: physiology and pharmacology
Reverse cholesterol transport describes the metabolic pathway moving cholesterol from peripheral tissues to the liver, maintaining cholesterol homeostasis, with HDL as its vehicle, a function believed to explain the inverse relationship between plasma HDL and atherosclerosis. This review examines drug-based stimulation of this transport process as a promising strategy for preventing and treating arterial disease, noting that only a few drugs are known to modify the factors involved. Clofibrate reduces cholesterol esterification, while newer fibric acids and anion-exchange resins are generally ineffective. Probucol directly increases CETP activity and mass, potentially improving the physiological process of cholesterol removal from tissues. The authors argue the limited available data on drug effects on reverse cholesterol transport should motivate the search for new agents that specifically stimulate this antiatherogenic process.
Original abstract
Reverse cholesterol transport identifies a series of metabolic events resulting in the transport of cholesterol from peripheral tissues to the liver and plays a major role in maintaining cholesterol homeostasis in the body. High density lipoproteins (HDL) are the vehicle of cholesterol in this reverse transport, a function believed to explain the inverse correlation between plasma HDL levels and atherosclerosis. An attempt to stimulate, by the use of drugs, this transport process seems to be of great promise in the prevention and treatment of arterial disease. Only few drugs are now known that can modify the activity of the various factors involved in the process. Clofibrate reduces cholesterol esterification, but the newer fibric acids are generally ineffective as anion-exchange resins. Probucol directly increases the activity and mass of cholesteryl ester transfer protein, thus possibly improving the physiological process of cholesterol removal from tissues. The few available data on the effects of drugs on reverse cholesterol transport should stimulate the search for new agents specifically stimulating this antiatherogenic process.
HDL biologymechanismspharmacology
Summary written by cetpinhibition.org from the published abstract; figures as published. Page updated 19 August 2026. Methods.