针对低密度脂蛋白胆固醇的新生物疗法
Praneet K Gill1, Robert A Hegele1
1Department of Medicine, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada.
The Canadian journal of cardiology
|August 10, 2023
概括
针对PCSK9和ANGPTL3等基因的新生物疗法提供了降低低密度脂蛋白胆固醇和预防心血管疾病的新方法. 这些以自然低胆固醇血症为灵感的治疗方法正在改变临床实践.
科学领域:
- 心血管医学 心血管医学
- 遗传学 是一个遗传学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 降低低密度脂蛋白胆固醇 (LDL-C) 是预防动脉样硬化心血管疾病 (ASCVD) 的关键.
- 单一性低胆固醇血症提供了对降低LDL-C的遗传点的洞察.
- PCSK9,ANGPTL3,MTTP和APOB基因中的致病变体与自然低胆固醇水平有关.
研究的目的:
- 审查针对参与脂质代谢的关键基因的新疗法的开发和临床应用.
- 突出说明蛋白转化酶潜素克辛9型 (PCSK9) 和血管蛋白类3 (ANGPTL3) 抑制剂对临床实践的影响.
- 讨论新兴疗法,这些疗法有可能长期或终身降低LDL-C.
主要方法:
- 针对降脂疗法的现有文献进行了重点审查.
- 讨论目前批准的针对PCSK9,ANGPTL3和MTTP的生物疗法.
- 临床前和临床试验阶段治疗的概述,包括疫苗和基因编辑方法.
主要成果:
- 针对PCSK9和ANGPTL3的几种疗法现在正在临床使用,包括单克隆抗体 (alirocumab,evolocumab,evinacumab) 和小干扰RNA (inclisiran).
- 微小的甘油三转移蛋白抑制剂洛米塔皮德也在临床上可用.
- 包括疫苗和基因编辑在内的多种新疗法正在开发中.
结论:
- 灵感来自单一性低胆固醇血症的生物疗法是管理升高的LDL-C和预防ASCVD的有效工具.
- 抑制PCSK9和ANGPTL3显著影响了心血管疾病治疗策略.
- 未来的疗法,特别是疫苗和基因编辑,有望持续,长期控制脂质水平.
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