A LONGITUDINAL ANALYSIS OF ALTERATION IN LECITHIN-CHOLESTEROL ACYLTRANSFERASE AND PARAOXONASE ACTIVITIES FOLLOWING LAPAROSCOPIC CHOLECYSTECTOMY RELATIVE TO OTHER PARAMETERS OF HDL FUNCTION AND THE ACUTE-PHASE RESPONSE

The composition of high-density lipoprotein (HDL) changes during infla mmation; however, potential changes of HDL function during inflammatio n and the effects of acute phase proteins that are either on the HDL p articles or in the serum have not been clarified. The concentrations o f C-reactive protein (CRP), serum amyloid A protein (apoSAA) isoforms, lipids and apolipoproteins, and the activities of lecithin-cholestero l acyltransferase (LCAT) and paraoxonase (PON) were measured before an d after laparoscopic cholecystectomy, in 12 patients with cholecystoli thiasis to clarify the function of acute-phase HDL and the relationshi p between acute-phase proteins and HDL functions. Both acute-phase apo SAA (A-apoSAA) and CRP increased, reached their maximum levels 3-6 day s after the operation, and then returned to preoperative levels after 2 weeks. In contrast, apolipoproteins and LCAT decreased reciprocally, reached their minimum levels 3-6 days after the operation, and return ed to preoperative levels after 2 weeks. However, PON decreased 3-6 da ys after the operation, and remained low even after 2 weeks. At the na dir the mean activities of LCAT and PON were 56 and 76% of the preoper ative levels, respectively. HDL-cholesterol or constitutive apoSAA did not change significantly. LCAT has been reported to be involved in re verse-cholesterol transport and PON to be preventive for lipid peroxid ation of low-density lipoprotein in vitro. Thus, during the acute phas e of inflammation, HDL may be altered to an atherogenic state due to a decrease in LCAT and PON activities, Therefore, this longitudinal ana lysis was carried out to determine whether HDL function is modified in a single episode of inflammation and thus may contribute to the occur rence of atherosclerotic disease in patients with chronic or recurrent acute inflammation.