Abstract-There are several well-documented functions of high-density lipoprotein (HDL) that may explain the ability of these lipoproteins to protect against atherosclerosis. The best recognized of these is the ability of HDL to promote the efflux of cholesterol from cells. This process may minimize the accumulation of foam cells in the artery wall. However, HDL has additional properties that may also be antiatherogenic. For example, HDL is an effective antioxidants. The major proteins of HDL, apoA-I and apoA-II, as well as other proteins such as paraoxonase that cotransport with HDL in plasma, are well-known to have antioxidant properties. As a consequence, HDL has the capacity to inhibit the oxidative modification of low-density lipoprotein (LDL) in a process that reduces the atherogenicity of these lipoproteins. HDL also possesses other antiinflammatory properties. By virtue of their ability to inhibit the expression of adhesion molecules in endothelial cells, they reduce the recruitment of blood monocytes into the artery wall. These antioxidant and antiinflammatory properties of HDL may be as important as its cholesterol efflux function in terms of protecting against the development of atherosclerosis. Key Words: antiinflammatory Ⅲ antioxidant Ⅲ atherosclerosis Ⅲ high-density lipoprotein I n epidemiological studies, high plasma levels of highdensity lipoproteins (HDLs) protect against the development of atherosclerosis. 1,2 The precise mechanism is uncertain, although most likely it is the consequence of one or more of the reported actions of HDL. 3 The best known of these relates to the ability of HDL to promote the efflux of cholesterol from cells in the artery wall. 4 However, HDLs have additional functions, some of which may be unrelated to their role in plasma lipid transport. For example, they bind lipopolysaccharide, 5 stimulate endothelial cell movement, 6 inhibit the synthesis of plateletactivating factor by endothelial cells, 7 and protect erythrocytes against the generation of procoagulant activity. 8 HDLs stimulate prostacyclin synthesis by endothelial cells. 9 They also bind prostacyclin and thus prolong its half-life. 10 They reduce epidermal growth factor-induced DNA synthesis in vascular smooth muscle cells. 11 HDLs are antithrombotic. 12 They modulate endothelial function, 13 probably by stimulating endothelial nitric oxide (NO) production. 14 HDLs also possess antioxidant and antiinflammatory activities. 3,[15][16][17][18][19][20][21] The degree to which any or all of these nonlipid transport functions of HDL contribute to a protection against atherosclerosis is still uncertain, although evidence is mounting that at least some of them may be especially important.This review focuses on the antioxidant and antiinflammatory properties of HDL (Figure 1). It summarizes the role of oxidation and inflammation in atherogenesis and describes how these processes may be inhibited by HDL. It concludes with an assessment of the potential clinical importance of the antioxidant and antiinflammatory propert...