Lee Justin M S, Choudhury Robin P
Department of Cardiology, Papworth Hospital, Cambridge, UK.
Expert Rev Cardiovasc Ther. 2010 Sep;8(9):1325-34. doi: 10.1586/erc.10.108.
Atherosclerosis regression has been demonstrated clearly in animal experimental models and, to a lesser extent, in human clinical studies. Imaging techniques for study of the arterial wall are playing a key role in promoting our appreciation of regression. LDL lowering remains the mainstay of current lipid treatment, but given the multiple antiatherosclerotic functions of HDL, including reverse cholesterol transport, agents that target HDL may represent the next generation of treatment for atherosclerotic disease. Currently available agents, including nicotinic acid, have documented antiatherosclerotic effects and trials examining clinical outcomes in the context of contemporary LDL treatment are now underway. Future approaches to HDL treatment may include cholesteryl ester transfer protein inhibitors and apolipoprotein A-I mimetics.
动脉粥样硬化的消退在动物实验模型中已得到明确证实，在人体临床研究中也有一定程度的体现。用于研究动脉壁的成像技术在增进我们对消退的认识方面发挥着关键作用。降低低密度脂蛋白（LDL）仍然是当前脂质治疗的主要手段，但鉴于高密度脂蛋白（HDL）具有多种抗动脉粥样硬化功能，包括逆向胆固醇转运，针对HDL的药物可能代表了动脉粥样硬化疾病的下一代治疗方法。目前可用的药物，包括烟酸，已被证明具有抗动脉粥样硬化作用，并且正在进行在当代LDL治疗背景下检验临床结局的试验。未来HDL治疗方法可能包括胆固醇酯转运蛋白抑制剂和载脂蛋白A-I模拟物。
