HDL作为治疗目标:我们应该放弃这个想法吗?
Floran Begue1, Marie Laurine Apalama1, Gilles Lambert2
1Inserm, UMR 1188 Diabète Athérothrombose Thérapies Réunion Océan Indien (DéTROI), Université de La Réunion, 97410, Saint-Pierre, France.
Current atherosclerosis reports
|December 5, 2023
概括
高密度脂蛋白 (HDL) 显示出抗炎和抗氧化功效. 尽管在过去的研究中,高密度胆固醇疗法并没有持续改善心血管健康,这促使重新评估高密度胆固醇作为直接治疗目标.
科学领域:
- 心血管科学 心血管科学
- 脂质代谢 脂质代谢是什么
- 药理学 药理学是指药理学的学科.
背景情况:
- 高密度脂蛋白 (HDL) 由于其抗动脉增生性质而闻名,包括逆胆固醇运输 (RCT),抗炎和抗氧化功能.
- 高密度脂一直是动脉样硬化心血管疾病 (ASCVD) 的长期治疗目标.
研究的目的:
- 审查HDL作为ASCVD治疗点的现状.
- 讨论最近临床试验结果对基于高密度胆固醇的疗法的影响.
- 探索超越ASCVD的基于HDL的治疗策略的未来方向.
主要方法:
- 审查关于HDL功能和治疗干预措施的现有文献.
- 对涉及高密度胆固醇调节药物和复制高密度胆固醇输液的主要临床试验结果的分析.
- 讨论关于优化HDL特性用于治疗应用的新兴研究.
主要成果:
- 之前试图提高HDL水平或注入复制的HDL并没有产生令人信服的心血管益处.
- 两个关键的临床试验 (CETP抑制剂Obicetrapib和复制的HDL输液) 正在进行中,这可能决定了HDL作为直接治疗标的未来.
- 作为治疗剂的HDL的有效性可能取决于优化其有益性质.
结论:
- 作为ASCVD的直接治疗标,HDL的作用是不确定的,目前正在进行的试验结果尚未公布.
- 未来的治疗策略可能会专注于增强HDL的有益功能,而不是仅仅增加其水平.
- 高脂可能通过优化其多方面的特性,超出心血管疾病的治疗前景.
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