Reverse cholesterol transport is transport of cholesterol from the tissues back to liver/VLDL. My question is why do the tissues have this extra cholesterol in the first place?

Why would you synthesise extra cholesterol when excellent feedback mechanisms exist - eg. SREBP SCAP INSIG path??

Does this happen only in the case of an atheromatous plaque? Nowhere else?

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    $\begingroup$ This is a great question, I have also wondered this many times but found no clear motivation or data in the literature. My guess is that there is some continuous loss of structural (membrane) lipids in all tissues that proliferate or renew themselves. Possibly the cholesterol in membranes of dead cells cannot be completely recycled (perhaps it gets irreversibly modified somehow). Pretty much all tissues have some rate of cholesterol synthesis, and proliferative tissues have high rates, which suggests continuous turnover. But I don't know for sure, just some food for thought ... $\endgroup$ – Roland Mar 5 '16 at 11:24
  • $\begingroup$ The problem is that we are taught all the cycles, and we learn them blindly. The big picture gets lost in the process. :( $\endgroup$ – Polisetty Mar 5 '16 at 11:27
  • $\begingroup$ Just remembered that I asked this related question some time ago. No responses yet ... biology.stackexchange.com/questions/41886/… $\endgroup$ – Roland Mar 7 '16 at 14:43
  • $\begingroup$ this source might be helpful: ncbi.nlm.nih.gov/pmc/articles/PMC2390860 $\endgroup$ – Siva Sankaran Dec 18 '19 at 9:53

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