Remaley Alan T, Amar Marcelo, Sviridov Dmitri
National Institutes of Health, Lipoprotein Metabolism Section, Pulmonary and Vascular Medicine Branch, National Heart, Lung, and Blood Institute, Bethesda, MD 20892-21508, USA.
Expert Rev Cardiovasc Ther. 2008 Oct;6(9):1203-15. doi: 10.1586/14779072.6.9.1203.
HDL-replacement therapy is a promising new treatment strategy involving the acute administration of HDL to rapidly stabilize patients at imminent risk for developing a myocardial infarction, such as those with acute coronary syndrome. This review will first focus on the anti-atherogenic mechanisms for HDL, such as the stimulation of the reverse cholesterol transport pathway, and then discuss the other potential beneficial biological effects of HDL on atherosclerosis. The various types of HDL-replacement therapies that are being investigated and developed will be reviewed and ongoing clinical trials and other possible clinical indications for HDL-replacement therapy besides the prevention of myocardial infarction will also be described. Finally, HDL-replacement therapy will be put into perspective by summarizing the current gaps in our knowledge of HDL metabolism and identifying challenges for future research in this area.
高密度脂蛋白替代疗法是一种有前景的新治疗策略，涉及急性给予高密度脂蛋白，以迅速稳定有发生心肌梗死迫在眉睫风险的患者，如急性冠状动脉综合征患者。本综述将首先聚焦于高密度脂蛋白的抗动脉粥样硬化机制，如刺激逆向胆固醇转运途径，然后讨论高密度脂蛋白对动脉粥样硬化的其他潜在有益生物学效应。将综述正在研究和开发的各种类型的高密度脂蛋白替代疗法，并描述正在进行的临床试验以及除预防心肌梗死之外高密度脂蛋白替代疗法的其他可能临床适应症。最后，通过总结我们目前在高密度脂蛋白代谢知识方面的差距并确定该领域未来研究的挑战，对高密度脂蛋白替代疗法进行全面审视。
