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Molecular aspects of hypercholesterolemia treatment: current perspectives and hopes

Najmeh Ahangari1, Majid Ghayour Mobarhan2, Amirhossein Sahebkar3,4

  • 1a Departement of Modern Sciences and Technologies, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran.

Annals of Medicine
|March 27, 2018
PubMed

Insights

Hypercholesterolemia affects 39% of adults. This review covers molecular insights into current and novel therapies for lowering low-density lipoprotein cholesterol (LDL-C), crucial for preventing cardiovascular disease.

Area of Science:

  • Cardiovascular Medicine
  • Molecular Biology
  • Pharmacology

Background:

  • Hypercholesterolemia, affecting 39% of adults, is characterized by elevated low-density lipoprotein cholesterol (LDL-C).
  • Genetic mutations in LDLR, ApoB, PCSK9, and LDLRAP impair LDL receptor-mediated clearance, leading to arterial LDL deposition, atherosclerosis, and premature cardiovascular disease.
  • Understanding the molecular basis is key to managing this prevalent condition.

Purpose of the Study:

  • To review molecular mechanisms of hypercholesterolemia.
  • To explore current and emerging therapeutic strategies for lowering LDL-C.
  • To highlight the impact of genetic factors on treatment.

Main Methods:

  • Literature review of molecular aspects of hypercholesterolemia.
  • Analysis of current therapeutic agents including statins, ezetimibe, bile acid sequestrants, and PCSK9 inhibitors.
  • Examination of novel RNA-based therapies and genetic contributions.

Main Results:

  • Identified LDLR, PCSK9, and ApoB as key genes involved in hypercholesterolemia.
  • Current treatments focus on LDL-C reduction through various drug classes.
  • RNA-based therapies represent a significant advancement in treatment strategies.

Conclusions:

  • Continued research into molecular pathways will enable more targeted hypercholesterolemia therapies.
  • Integrated approaches combining lifestyle changes, disease management, and pharmacotherapy are essential.
  • Pharmacogenetic considerations are vital for optimizing treatment efficacy and safety.

Keywords:
Hypercholesterolemialipid-lowering drugslow-density lipoprotein cholesteroltherapy

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