Progress in understanding of role of high density lipoprotein, apolipoprotein A-I, and serum amyloid A in sepsis
High-density lipoprotein (HDL) can bind and neutralize the endotoxin of Gram-negative bacteria and lipoteichoic acid of Gram-positive bacteria through apolipoprotein A-I (ApoA-I) during sepsis. The expression of serum amyloid A (SAA) is significantly increased in sepsis, and ApoA-I in HDL is replaced by SAA, resulting in a significant reduction in plasma HDL levels, an independent risk factor for sepsis. HDL has dysfunction during sepsis, and the exact mechanism of SAA in altering HDL structure and function is not clear. This paper reviews the change trend of HDL, ApoA-I, and SAA during sepsis, the interaction between them, and the clinical application of various indexes, to provide a theoretical basis for the further study of lipoproteins and related apolipoproteins in sepsis.
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