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ANGPTL3 作为高血脂和动脉粥样硬化的药物靶点。

ANGPTL3 as a Drug Target in Hyperlipidemia and Atherosclerosis.

机构信息

Department of Internal Medicine, Faculty of Health Sciences, Division of Endocrinology and Metabolism, University of the Witwatersrand, Johannesburg, South Africa.

出版信息

Curr Atheroscler Rep. 2022 Dec;24(12):959-967. doi: 10.1007/s11883-022-01071-1. Epub 2022 Nov 11.


DOI:10.1007/s11883-022-01071-1
PMID:36367663
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9650658/
Abstract

PURPOSE OF REVIEW: Elevated low-density lipoprotein cholesterol (LDL-C) and triglyceride-rich lipoproteins (TRLs) or remnants are important risk factors for the development of atherosclerotic cardiovascular disease (ASCVD). The ongoing challenge of not being able to achieve recommended LDL-C targets despite maximally tolerated lipid-lowering therapy (LLT) has led to the development of novel therapeutic agents including angiopoietin-like 3 (ANGPTL3) inhibitors. RECENT FINDINGS: ANGPTL3 is a glycoprotein produced by the liver that inhibits lipoprotein lipase and endothelial lipase. Data from genetic and clinical studies have shown that a lower ANGPTL3 level is associated with lower plasma LDL-C, triglyceride (TG), and other lipoproteins. Pharmacological inactivation of ANGPTL3 with the monoclonal antibody, evinacumab, results in a 50% reduction in LDL-C, even in patients with homozygous familial hypercholesterolemia (HoFH). The safe and effective targeted delivery of nucleic acid-based therapies will shape the future of the lipid arena. ANGPTL3 is a novel target in lipoprotein metabolism, targeting not only LDL-C via an LDL-receptor (LDLR) independent mechanism but also TRLs and carries a significant promise for further ASCVD risk reduction.

摘要

目的综述:升高的低密度脂蛋白胆固醇(LDL-C)和富含甘油三酯的脂蛋白(TRLs)或残粒是动脉粥样硬化性心血管疾病(ASCVD)发展的重要危险因素。尽管进行了最大限度耐受的降脂治疗(LLT),但仍无法达到推荐的 LDL-C 目标,这一持续存在的挑战导致了新型治疗药物的发展,包括血管生成素样 3(ANGPTL3)抑制剂。

最近的发现:ANGPTL3 是一种由肝脏产生的糖蛋白,可抑制脂蛋白脂肪酶和内皮脂肪酶。遗传和临床研究的数据表明,ANGPTL3 水平较低与血浆 LDL-C、甘油三酯(TG)和其他脂蛋白较低相关。单克隆抗体依维莫司(evinacumab)对 ANGPTL3 的药理学失活可使 LDL-C 降低 50%,即使在纯合家族性高胆固醇血症(HoFH)患者中也是如此。基于核酸的治疗方法的安全有效靶向递送将塑造脂质领域的未来。ANGPTL3 是脂蛋白代谢的一个新靶点,不仅通过 LDLR 独立机制靶向 LDL-C,还靶向 TRLs,并为进一步降低 ASCVD 风险带来了巨大希望。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65c1/9650658/390521629856/11883_2022_1071_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65c1/9650658/390521629856/11883_2022_1071_Fig1_HTML.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/65c1/9650658/390521629856/11883_2022_1071_Fig1_HTML.jpg

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ANGPTL3 as a Drug Target in Hyperlipidemia and Atherosclerosis.

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[2]
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[3]
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[4]
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[5]
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[6]
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[7]
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JACC Basic Transl Sci. 2025-5

[8]
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[9]
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本文引用的文献

[1]
Effect of Vupanorsen on Non-High-Density Lipoprotein Cholesterol Levels in Statin-Treated Patients With Elevated Cholesterol: TRANSLATE-TIMI 70.

Circulation. 2022-5-3

[2]
A Tale of Two New Targets for Hypertriglyceridaemia: Which Choice of Therapy?

BioDrugs. 2022-3

[3]
Vaccine targeting ANGPTL3 ameliorates dyslipidemia and associated diseases in mouse models of obese dyslipidemia and familial hypercholesterolemia.

Cell Rep Med. 2021-11-16

[4]
Transcriptomic therapy for dyslipidemias utilizing nucleic acids targeted at ANGPTL3.

Future Cardiol. 2022-2

[5]
ANGPTL3 as therapeutic target.

Curr Opin Lipidol. 2021-12-1

[6]
A VLP-based vaccine targeting ANGPTL3 lowers plasma triglycerides in mice.

Vaccine. 2021-9-24

[7]
Triglyceride-rich lipoproteins and their remnants: metabolic insights, role in atherosclerotic cardiovascular disease, and emerging therapeutic strategies-a consensus statement from the European Atherosclerosis Society.

Eur Heart J. 2021-12-14

[8]
Harnessing the Potential of CRISPR/Cas in Atherosclerosis: Disease Modeling and Therapeutic Applications.

Int J Mol Sci. 2021-8-5

[9]
Regulation of lipoprotein metabolism by ANGPTL3, ANGPTL4, and ANGPTL8.

Am J Physiol Endocrinol Metab. 2021-10-1

[10]
Angiopoietin-Like Protein 3 (ANGPTL3) Modulates Lipoprotein Metabolism and Dyslipidemia.

Int J Mol Sci. 2021-7-7

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