Molecular regulation of cholesterol metabolism: HDL-based intervention through drugs and diet

Amit Kumar Rai1, Patrizia Debetto1, Federica Dabbeni Sala1

  • 1Department of Pharmaceutical and Pharmacological Sciences, University of Padova, Largo E. Meneghetti, 2, 35131 Padova, Italy.

Insights

New strategies targeting cholesterol metabolism, including pharmacological and nutritional approaches, show promise for cardiovascular disease treatment. Natural products offer a low-cost, safe alternative to traditional drugs.

Area of Science:

  • Cardiovascular Science
  • Metabolic Research
  • Pharmacology

Background:

  • Arterial cholesterol overload is a primary driver of cardiovascular diseases.
  • Current anticholesterolemic drugs have limitations in efficacy and adverse effects.

Purpose of the Study:

  • To review innovative pharmacological and nutritional strategies for cholesterol metabolism control.
  • To analyze emerging therapeutic interventions for cardiovascular disease.

Main Methods:

  • Review of current research on pharmacological interventions targeting high-density lipoprotein (HDL) metabolism and reverse cholesterol transport (RCT).
  • Analysis of nutritional interventions including fibers, phytosterols, and probiotics influencing cholesterol absorption and RCT.
  • Examination of genetic control, receptor agonism, and protein inhibition in pharmacological approaches.

Main Results:

  • Pharmacological strategies involve targeting apolipoprotein A-I (ApoA-I), liver X-receptor alpha (LXRalpha), cholesteryl ester transport protein (CETP), scavenger receptor BI (SR-BI), and ecto F0F1ATPase/synthase.
  • Nutritional interventions focus on modulating cholesterol absorption and reabsorption via fibers, phytosterols, and probiotics, impacting the final steps of RCT.
  • Emerging biotechnological research is yielding promising probiotics, fibers, and phytosterols.

Conclusions:

  • Innovative pharmacological and nutritional strategies offer new therapeutic avenues for managing cholesterol metabolism.
  • Natural products like probiotics, fibers, and phytosterols present advantages of reduced adverse effects and lower cost compared to traditional drugs.
  • While new drug development is ongoing, natural interventions are nearing clinical readiness.

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