Goldstein Joseph L, Brown Michael S
Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA.
Cell. 2015 Mar 26;161(1):161-172. doi: 10.1016/j.cell.2015.01.036.
One-fourth of all deaths in industrialized countries result from coronary heart disease. A century of research has revealed the essential causative agent: cholesterol-carrying low-density lipoprotein (LDL). LDL is controlled by specific receptors (LDLRs) in liver that remove it from blood. Mutations that eliminate LDLRs raise LDL and cause heart attacks in childhood, whereas mutations that raise LDLRs reduce LDL and diminish heart attacks. If we are to eliminate coronary disease, lowering LDL should be the primary goal. Effective means to achieve this goal are currently available. The key questions are: who to treat, when to treat, and how long to treat.
在工业化国家，四分之一的死亡是由冠心病导致的。一个世纪的研究已揭示出其主要致病因素：携带胆固醇的低密度脂蛋白（LDL）。LDL由肝脏中的特定受体（LDLR）控制，这些受体可将其从血液中清除。消除LDLR的突变会使LDL升高，并在儿童期引发心脏病发作，而增加LDLR的突变则会降低LDL并减少心脏病发作。如果我们要消除冠心病，降低LDL应是首要目标。目前已有实现这一目标的有效方法。关键问题是：治疗谁、何时治疗以及治疗多久。
