White C Roger, Datta Geeta, Zhang Zhenghao, Gupta Himanshu, Garber David W, Mishra Vinod K, Palgunachari Mayakonda N, Handattu Shaila P, Chaddha Manjula, Anantharamaiah G M
Vascular Biology and Hypertension Program, University of Alabama, Birmingham, 1046 Zeigler Research Building, 703 South 19th Street, Birmingham, AL 35294, USA.
Curr Atheroscler Rep. 2008 Oct;10(5):405-12. doi: 10.1007/s11883-008-0063-6.
3-Hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are currently the drug of choice for the clinical management of elevated low-density lipoprotein (LDL) cholesterol. Although statin treatment provides an overall improvement in outcomes, clinical trial data reveal a significant number of cardiac events despite reaching targeted LDL levels. A low serum high-density lipoprotein (HDL) cholesterol level is an independent predictor of cardiovascular risk. Accordingly, there has been interest in determining whether HDL elevation, in addition to LDL lowering, further reduces risk in patients with coronary artery disease. Several commonly prescribed lipid-lowering therapies modestly raise HDL, but their use may be limited by the development of adverse reactions. Emerging data suggest that HDL quality and function may also be significantly reduced by atherosclerosis and other inflammatory diseases. The goal of this review is to discuss the current status of HDL therapeutics, with emphasis on a novel class of agent, the apolipoprotein A-I mimetic peptides, which improve the functional properties of HDL cholesterol.
3-羟基-3-甲基戊二酰辅酶A还原酶抑制剂（他汀类药物）目前是临床管理低密度脂蛋白（LDL）胆固醇升高的首选药物。尽管他汀类药物治疗能总体改善预后，但临床试验数据显示，即便达到了目标LDL水平，仍有大量心脏事件发生。血清高密度脂蛋白（HDL）胆固醇水平低是心血管风险的独立预测因素。因此，人们一直关注除降低LDL外，升高HDL是否能进一步降低冠心病患者的风险。几种常用的降脂疗法能适度升高HDL，但它们的使用可能会因不良反应的发生而受到限制。新出现的数据表明，动脉粥样硬化和其他炎症性疾病也可能显著降低HDL的质量和功能。本综述的目的是讨论HDL治疗的现状，重点是一类新型药物——载脂蛋白A-I模拟肽，它能改善HDL胆固醇的功能特性。
