Watts Gerald F, Raal Frederick J, Chan Dick C
School of Medicine, University of Western Australia, Perth, Australia.
Department of Cardiology & Internal Medicine, Lipid Disorders Clinic, Royal Perth Hospital, Perth, Australia.
Future Cardiol. 2022 Feb;18(2):143-153. doi: 10.2217/fca-2021-0096. Epub 2021 Oct 15.
Angiopoietin-like protein 3 (ANGPTL3) is a key physiological regulator of plasma lipid and lipoprotein metabolism that involves the control of enzymes, lipoprotein and endothelial lipases. Inhibition of ANGPTL3 offers a new approach for correcting the health risks of dyslipidemia, including familial hypercholesterolemia, mixed hyperlipidemia, metabolic syndrome and/or severe hypertriglyceridemia. ANGPTL3 inhibition with nucleic acid-based antisense oligonucleotide and siRNA can correct dyslipidemia chiefly by reducing production and increasing catabolism of triglyceride-rich lipoprotein and LDL particles. Early clinical trials have demonstrated that these agents can safely and effectively lower plasma triglyceride and LDL-cholesterol levels by up to 70 and 50%, respectively. However, the long-term safety and cost-effectiveness of these agents await to be confirmed in an ongoing and future clinical trials.
血管生成素样蛋白3(ANGPTL3)是血浆脂质和脂蛋白代谢的关键生理调节因子,涉及对酶、脂蛋白和内皮脂肪酶的调控。抑制ANGPTL3为纠正血脂异常的健康风险提供了一种新方法,这些血脂异常包括家族性高胆固醇血症、混合性高脂血症、代谢综合征和/或严重高甘油三酯血症。基于核酸的反义寡核苷酸和小干扰RNA对ANGPTL3的抑制作用主要通过减少富含甘油三酯的脂蛋白和低密度脂蛋白颗粒的产生并增加其分解代谢来纠正血脂异常。早期临床试验表明,这些药物可分别安全有效地降低血浆甘油三酯和低密度脂蛋白胆固醇水平达70%和50%。然而,这些药物的长期安全性和成本效益仍有待正在进行的和未来的临床试验予以证实。