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. 2015 Feb 25;67(3):616–625. doi: 10.1002/art.38974

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© 2015 The Authors. Arthritis & Rheumatology is published by Wiley Periodicals, Inc. on behalf of the American College of Rheumatology.

This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.

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Diagram of reverse cholesterol transport. Reverse cholesterol transport starts with the transfer of free cholesterol (FC) and phospholipid to a lipid‐poor pre–β high‐density lipoprotein (pre–β‐HDL) particle. Esterification of free cholesterol to cholesterol ester (CE) by lecithin:cholesterol acyltransferase (LCAT) then generates a mature HDL particle. From this mature HDL particle, cholesterol ester may be transferred to low‐density lipoprotein (LDL) via cholesterol ester transfer protein (CETP) and then delivered to the liver via the LDL receptor (LDLr). Alternatively, selective cholesterol ester uptake via scavenger receptor class B type I (SR‐BI) can deliver cholesterol ester directly to the liver from HDL, regenerating a lipid‐poor apolipoprotein (Apo) A‐I–containing particle. Once delivered to the liver, cholesterol can leave the body via biliary secretion.