Meyer Philippe, Nigam Anil, Marcil Michel, Tardif Jean-Claude
Department of Medicine and Research Center, Montreal Heart Institute, QC, Canada.
Curr Atheroscler Rep. 2009 Sep;11(5):329-33. doi: 10.1007/s11883-009-0049-z.
Low levels of high-density lipoprotein cholesterol (HDL-C) represent a major cardiovascular risk factor that is only modestly influenced by currently available drugs. Consequently, there has been interest in developing new therapeutic agents specifically targeting HDL-C to reduce risk in patients with coronary artery disease. One strategy involves the administration of therapies that mimic HDL-C or its properties, including reconstituted HDL, apolipoprotein A-I (apoA-I), apoA-I Milano, and apoA-I mimetic peptides. The atheroprotective effects of reconstituted HDL, apoA-I, and apoA-I Milano have been well documented in animal studies, and two recent clinical trials also provided encouraging results. The most investigated apoA-I mimetic peptide, D-4F, was shown to significantly reduce atherosclerotic lesions in animal models but data in humans are scarce. HDL-C mimetic agents constitute a promising novel strategy to reduce coronary artery disease risk but require further study in larger clinical trials.
低水平的高密度脂蛋白胆固醇（HDL-C）是主要的心血管危险因素，目前可用药物对其影响较小。因此，人们对开发专门针对HDL-C的新型治疗药物以降低冠心病患者的风险很感兴趣。一种策略是给予模拟HDL-C或其特性的疗法，包括重组HDL、载脂蛋白A-I（apoA-I）、载脂蛋白A-I米兰（apoA-I Milano）和载脂蛋白A-I模拟肽。重组HDL、apoA-I和apoA-I米兰在动物研究中的抗动脉粥样硬化作用已得到充分证明，最近的两项临床试验也提供了令人鼓舞的结果。研究最多的载脂蛋白A-I模拟肽D-4F在动物模型中显示可显著减少动脉粥样硬化病变，但人类数据较少。HDL-C模拟剂是降低冠心病风险的一种有前景的新策略，但需要在更大规模的临床试验中进一步研究。
