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We appreciate the comments of Dr Goldstein and Drs Mazur and Herbert regarding our recent report in JAMA. We have data available on changes in low-density lipoprotein and high-density lipoprotein (HDL) cholesterol concentrations in five of the eight patients reported (Table). In three of these patients HDL-cholesterol decreased slightly, but in all instances the decrease in HDL-cholesterol was proportionally less than the decrease in low-density lipoprotein cholesterol, resulting in a lower low-density lipoprotein/HDL cholesterol ratio. In one of the patients HDL-cholesterol levels increased during GM-CSF therapy and in the other patient there was no real change in HDL-cholesterol levels. The low-density lipoprotein/HDL cholesterol ratios decreased in all patients, a favorable direction in considering the possible treatment or prevention of atherosclerosis with GM-CSF or other factors that use similar mechanisms.Our findings are indeed preliminary, but we are actively exploring the mechanism of action of GM-CSF's cholesterollowering activity. As
Nimer SD, Champlin RE, Golde DW. Lowering Cholesterol With Granulocyte-Macrophage Colony-Stimulating Factor-Reply. JAMA. 1989;261(16):2332. doi:10.1001/jama.1989.03420160055026
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