Le lipoproteine ad alta densità: uno strumento polivalente contro il cancro? = High density lipoproteins as a multitasking tool to fight cancer

High density lipoproteins are well known for their cardioprotective role. Their ability to inhibit the development and progression of atherosclerosis is likely due to their role in the reverse transport of cholesterol from peripheral tissues to the liver for excretion and to their antioxidant and anti-inflammatory properties. Since lipids, oxidative stress and inflammation can promote cancer cell proliferation, HDL could affect tumor development and progression through the same mechanisms as well. Several alterations of cellular metabolism, including those affecting cholesterol, are shared by many types of cancers. Besides fatty acids, cholesterol and its metabolites were shown to play a key role in cancer cell proliferation. In this context, when cancer cells are exposed to HDL, cholesterol content is reduced, with an overall rewiring of cell metabolism. In addition, in vitro and in vivo studies showed that HDL could limit the formation and availability of pro-oxidant and pro-inflammatory molecules in the tumor microenvironment. Here, HDL can also promote immune surveillance and reduce angiogenesis. Finally, HDL-like particles can be used as delivery agents for the selective uptake of antineoplastic agents by cancer cells, thanks to their binding to the scavenger receptor BI. In this context, a key advantage is that the delivery agent has an intrinsic antitumor activity per se, thus likely rendering cancer cells more sensitive to antineoplastic agents.