敢于梦想:准脂蛋白作为一种因果和增加风险的因素
Marlys L Koschinsky1, Erik S G Stroes2, Florian Kronenberg3
1Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada; Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada.
Pharmacological research
|July 5, 2023
概括
脂蛋白 (Lp) 是动脉样硬化心血管疾病的基因控制风险因素. 针对mRNA的新型疗法在显著降低Lp (a) 水平方面表现有前途.
科学领域:
- 心血管研究研究心血管研究
- 脂蛋白代谢 脂蛋白的代谢
- 遗传学和动脉样硬化
背景情况:
- 脂蛋白 (Lp) 是心血管研究的一个重要焦点,因为它与心血管结果的关联.
- 升高的Lp(a) 水平很普遍,特别是在白人和黑人人群体中,这代表了主要的公共卫生问题.
- 最近的指导方针和共识声明强调了理解Lp (a) 在心血管疾病 (CVD) 中的重要性.
研究的目的:
- 审查Lp(a) 与心血管结果之间的因果关系,包括心肌梗塞和大动脉狭窄.
- 探索Lp(a) 对心血管疾病的贡献背后的机制.
- 讨论对Lp (a) 生产和清除的代谢见解,以及当前/未来的治疗策略.
主要方法:
- 对最近关于Lp的指导方针和共识声明的审查.
- 对遗传研究的分析表明Lp(a) 与动脉样硬化心血管疾病 (ASCVD) 之间存在因果关系.
- 讨论正在进行的新型Lp(a) 降低疗法II和III期临床试验.
主要成果:
- 遗传证据强烈支持终身升高的Lp (a) 和ASCVD风险增加之间的因果关系.
- 在Lp(a) 度和各种ASCVD终点之间存在连续的关联.
- 新型的mRNA向疗法,包括反意义寡核酸 (ASO) 和短干扰RNA (siRNA),可以将Lp(a) 降低95%以上.
结论:
- 脂蛋白是动脉样硬化心血管疾病和大动脉狭窄症的基因决定的独立风险因素.
- 用新型mRNA疗法准Lp(a) 是减少心血管风险的一个有希望的治疗途径.
- 进一步的临床试验至关重要,以评估这些新兴的Lp降低治疗的疗效和安全性.
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