Background: Autoimmune diseases are closely associated with cardiovascular diseases (CVD). Over
the last decades, the comprehension of atherosclerosis, the principal initiator of CVD, evolved from a lipidcentered
disease to a predominant inflammatory and immune response-driven disease displaying features of autoimmunity
against a broad range of auto-antigens, including lipoproteins. Among them, high density lipoproteins
(HDL) are important actors of cholesterol transport and bear several anti-atherogenic properties, raising a growing
interest as therapeutic targets to decrease atherosclerosis and CVD burden, with nevertheless rather disappointing
results so far. Reflecting HDL composition complexity, autoimmune responses and autoantibodies
against various HDL components have been reported.
Results: In this review, we addressed the important complexity of humoral autoimmunity towards HDL and particularly
how this autoimmune response could help improving our understanding of HDL biological implication
in atherosclerosis and CVD. We also discussed several issues related to specific HDL autoantibody subclasses
characteristics, including etiology, prognosis and pathological mechanisms according to Rose criteria.
Conclusion: Finally, we addressed the possible clinical value of using these antibodies not only as potential biomarkers
of atherogenesis and CVD, but also as a factor potentially mitigating the benefit of HDL-raising therapies.