[Mechanism of action of antilipemic drugs]

The study of the modes of action of lipid lowering drugs is important in order to evaluate their effects on the different lipid fractions and their possible secondary effects. These studies include: direct and indirect measurements of cholesterol absorption, the measurement of the principal enzymatic activities implicated in lipoprotein metabolism, especially those of lipases which play a fundamental role in the metabolism of particles rich in triglycerides and the inverse transport of cholesterol, and, finally, the measurement of intracellular enzyme activities. These last analyses are generally much more complex. Despite recent advances in all these investigative techniques, the mechanisms of action of many lipid lowering drugs remain obscure. Many have indirect modes of action like the inhibition of hydroxymethyl-glutaryl CoA by the fibrates and the mechanisms of action of the most recently introduced drugs are more complex than usually described. All these factors are important because the development of atherosclerosis depends on qualitative variations of the lipoproteins.