Department of Medical Biotechnology, Nanotechnology Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
Second Propedeutic Department of Internal Medicine, Medical School, Aristotle University of Thessaloniki, Hippocration Hospital, Thessaloniki, Greece.
J Cell Physiol. 2019 Aug;234(8):12581-12594. doi: 10.1002/jcp.28134. Epub 2019 Jan 13.
Elevated plasma lipoprotein(a) (Lp(a)) levels are associated with an increased risk of cardiovascular disease (CVD). Hitherto, niacin has been the drug of choice to reduce elevated Lp(a) levels in hyperlipidemic patients but its efficacy in reducing CVD outcomes has been seriously questioned by recent clinical trials. Additional drugs may reduce to some extent plasma Lp(a) levels but the lack of a specific therapeutic indication for Lp(a)-lowering limits profoundly reduce their use. An attractive therapeutic option is natural products. In several preclinical and clinical studies as well as meta-analyses, natural products, including l-carnitine, coenzyme Q , and xuezhikang were shown to significantly decrease Lp(a) levels in patients with Lp(a) hyperlipoproteinemia. Other natural products, such as pectin, Ginkgo biloba, flaxseed, red wine, resveratrol and curcuminoids can also reduce elevated Lp(a) concentrations but to a lesser degree. In conclusion, aforementioned natural products may represent promising therapeutic agents for Lp(a) lowering.
血浆脂蛋白（a）（Lp（a））水平升高与心血管疾病（CVD）风险增加有关。迄今为止，烟酸一直是降低高脂血症患者升高的 Lp（a）水平的首选药物，但最近的临床试验严重质疑了其降低 CVD 结局的疗效。其他药物可以在一定程度上降低血浆 Lp（a）水平，但缺乏针对 Lp（a）降低的特定治疗指征，极大地限制了它们的使用。一种有吸引力的治疗选择是天然产物。在几项临床前和临床研究以及荟萃分析中，天然产物，包括左旋肉碱、辅酶 Q 和血脂康，被证明可显著降低 Lp（a）高脂蛋白血症患者的 Lp（a）水平。其他天然产物，如果胶、银杏叶、亚麻籽、红酒、白藜芦醇和姜黄素，也可以降低升高的 Lp（a）浓度，但程度较小。总之，上述天然产物可能是降低 Lp（a）的有前途的治疗药物。
