Kirmizis Dimitrios, Chatzidimitriou Dimitrios
Aristotle University, Karavangeli 19 Str., Kalamaria, Thessaloniki, Greece.
Drug Des Devel Ther. 2009 Sep 21;3:191-204. doi: 10.2147/dddt.s5407.
Statins (3-hydroxy-3-methyl glutaryl coenzyme A [HMG-CoA] reductase inhibitors) are the most commonly used lipid-lowering drugs. Their main lipid-lowering effect is achieved by an increase in the expression of low-density lipoprotein cholesterol receptors associated with inhibition of cholesterol synthesis through inhibition of HMG-CoA reductase - the first and rate-limiting step in cholesterol synthesis. However, beyond cholesterol synthesis inhibition, inhibition of the HMG-CoA reductase affects as well the synthesis of other molecules with significant roles in different, yet often intercalating, metabolic pathways. On this basis, and supported by an increasing series of advocating epidemiological and experimental data, an extended dialogue has been established over the last few years regarding the nonlipid or "pleiotropic" actions of statins.
他汀类药物(3-羟基-3-甲基戊二酰辅酶A [HMG-CoA] 还原酶抑制剂)是最常用的降脂药物。它们的主要降脂作用是通过增加低密度脂蛋白胆固醇受体的表达来实现的,该受体与通过抑制HMG-CoA还原酶抑制胆固醇合成有关,而HMG-CoA还原酶是胆固醇合成的第一步和限速步骤。然而,除了抑制胆固醇合成外,HMG-CoA还原酶的抑制还会影响其他分子的合成,这些分子在不同但通常相互交织的代谢途径中具有重要作用。在此基础上,并得到越来越多支持性的流行病学和实验数据的支持,在过去几年里,关于他汀类药物的非脂质或“多效性”作用展开了广泛的讨论。