Vrablík Michal, Češka Richard
Vnitr Lek. 2014 Nov;60(11):949-57.
Options for modification of lipoprotein metabolism and, thus, for reduction of atherothrombotic complication have widened over recent years. Apart from the development of novel approaches new pharmacological formulations of common lipid lowering drugs have been prepared- e.g. statin-containing nanoparticles, fibrate nanoparticles with a much higher bioavailability etc. Even the oldest lipid lowering agents - resins - have not been forgotten due to its once again discovered positive impact of these agents on glucose homeostasis while optimally complementing the action of statins. Clinical trials of therapies targeting HDL particle metabolism are being in progress despite we have not gathered any unambiguous evidence of positive effect of the CETP inhibitors or apoA1 mime-tics on the progression of atherosclerosis. Brand new approaches in the treatment of dyslipidemia including MTTP and PCSK9 inhibition or therapies utilizing anti-sense technologies rapidly accumulate evidence from clinical studies. We have already learned about their lipid-modifying efficacy particularly in patients with familial hypercholesterolemia, however, data from other patients´ populations can be expected quite soon.
近年来，调节脂蛋白代谢从而降低动脉粥样硬化血栓形成并发症的方法有所增加。除了开发新方法外，还制备了常见降脂药物的新药理学制剂，例如含他汀类药物的纳米颗粒、生物利用度高得多的贝特类纳米颗粒等。即使是最古老的降脂药物——树脂，也因其对葡萄糖稳态再次发现的积极影响以及对他汀类药物作用的最佳补充作用而未被遗忘。尽管我们尚未收集到任何明确的证据表明CETP抑制剂或载脂蛋白A1模拟物对动脉粥样硬化进展有积极作用，但针对HDL颗粒代谢的治疗临床试验仍在进行中。治疗血脂异常的全新方法，包括抑制MTTP和PCSK9或利用反义技术的疗法，正在迅速积累来自临床研究的证据。我们已经了解到它们的脂质调节功效，特别是在家族性高胆固醇血症患者中，不过，预计很快会有来自其他患者群体的数据。
