Transient increases in HDL cholesterol observed in patients with Systemic Inflammatory Response Syndrome are interpreted as a significant reverse cholesterol transport mechanism delivering cholesterol to adrenal glands.

“Anytime a patient came in and they were septic or under great stress so they had what's called systemic inflammatory response syndrome sirs so you could be in a car accident you were shot you have a you know a horrible infection their HDL cholesterol would transiently take a huge bump and I didn't think anything but at the time other than it was neat it's like wow 2 X bump in HDL cholesterol overnight I think I you now look back and interpret those data as huge reverse cholesterol transport now the HDL is going out of its way to deliver cholesterol to probably the adrenal glands first and foremost because the enormous uptick of glucocorticoid even epinephrine or epinephrine are needed”