Reverse cholesterol transport

Reverse Cholesterol Transport (RCT) is a critical biological process where HDL (high-density lipoprotein) particles transport cholesterol from peripheral tissues back to the liver. This process is crucial for removing cholesterol from the body, including from arterial plaques, which can be instrumental in preventing and possibly reversing atherosclerosis.

• HDL's Role in RCT: HDL particles, particularly the larger HDL particles, are indicative of active reverse cholesterol transport. The larger size of HDL reflects its function of carrying cholesterol back to the liver from peripheral sites, such as plaques in the arteries. These larger HDL particles are more beneficial in this respect than smaller HDL particles 1.

• Complexity of Cholesterol Transport: Contrary to common perception, the role of LDL (low-density lipoprotein) is also significant in reverse cholesterol transport. In humans, LDL plays a major role in transporting cholesterol back to the liver, often transferring it to HDLs which then take it to the liver 2.

Thus, the process of reverse cholesterol transport is a coordinated action involving various lipoproteins, primarily HDL, and to some extent LDL, which together help maintain cholesterol balance and cardiovascular health.