Fibrates

Area of Science:

• Cardiovascular Science
• Pharmacology
• Molecular Biology

Background:

• Atherosclerosis of large arteries is a primary cause of cerebro- and cardiovascular diseases.
• The pathophysiology of coronary and cerebrovascular atherosclerosis is complex and multifactorial.
• Hypolipidemic drugs, such as fibrates, are used to manage lipid levels and cardiovascular risk.

Purpose of the Study:

• To review the multifaceted effects of fibrates on atherosclerosis development.
• To highlight the role of fibrates in modulating lipid metabolism and inflammation.
• To explore the mechanism of action of fibrates via peroxisome-proliferator activated receptor-alpha (PPAR-α) activation.

Main Methods:

• Literature review of studies on fibrate therapy and atherosclerosis.
• Analysis of preclinical and clinical data on fibrate's impact on atherosclerotic lesions.
• Examination of the molecular pathways influenced by fibrates, particularly PPAR-α signaling.

Main Results:

• Fibrates effectively lower triglyceride levels and modestly increase HDL cholesterol.
• Activation of PPAR-α by fibrates leads to reduced expression of inflammatory genes in vascular cells.
• Fibrates have demonstrated a capacity to slow the progression of atherosclerotic lesions in various vascular beds.

Conclusions:

• Fibrates represent a significant therapeutic option for managing atherosclerosis.
• The pleiotropic effects of fibrates, beyond lipid-lowering, contribute to their atheroprotective properties.
• Targeting PPAR-α with fibrates offers a promising strategy to combat cardiovascular disease progression.