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Apolipoprotein A-I (apo A-I) is the major protein component of high-density lipoprotein (HDL) in plasma. It is encoded by the APOA1 gene and plays a central role in reverse cholesterol transport, promoting cholesterol efflux from tissues to the liver for excretion. Apo A-I acts as a cofactor for lecithin-cholesterol acyltransferase (LCAT), which is responsible for forming most plasma cholesteryl esters[3][2]. Beyond its lipid-transport functions, apo A-I exhibits anti-inflammatory properties by modulating immune cell activity and inhibiting inflammatory cytokine production[6][4]. It also has potential anti-atherogenic effects and may stabilize prostacyclin to prevent platelet aggregation[4]. Recombinant forms such as apo A-I Milano have been investigated for their ability to reduce progression of atherosclerosis and stabilize plaques[5]. Defects in APOA1 are associated with HDL deficiencies like Tangier disease and systemic non-neuropathic amyloidosis[3].
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