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他汀类药物的多效性:他汀类药物更广泛应用的困境。

Pleotropic effects of statins: the dilemma of wider utilization of statin.

作者信息

Choudhary Ambika, Rawat Ujjawal, Kumar Piyush, Mittal Piyush

机构信息

Teerthanker Mahaveer College of Pharmacy, Teerthanker Mahaveer University, Moradabad, India.

出版信息

Egypt Heart J. 2023 Jan 5;75(1):1. doi: 10.1186/s43044-023-00327-8.

Abstract

BACKGROUND

Apart from reducing the circulating LDL-c and the number of cardiovascular cases as well as fatalities, statins have auxiliary non-lipid-related or cholesterol independent effects, the pleiotropic effects. The aim of the present review is to understand the pleotropic effects of statins.

MAIN BODY

Cardiovascular disease (CVD) is presently the major cause of patient misery as well as mortality among non-communicable diseases (NCDs) in the world. Despite the fact that statins are the most extensively affirmed, prescribed and evidence-based lipid-lowering medicine worldwide that curtail low density lipoprotein cholesterol (LDL-c) levels and the number of cardiovascular cases as well as deaths, statins also elicit auxiliary non-lipid-related or cholesterol independent effects, the pleiotropic effects. Improved endothelial function, significantly lowered oxidative stress, atherosclerotic plaque stabilization, immunomodulatory, cessation of vascular smooth muscle proliferation, effects on bone metabolism, anti-inflammatory, antithrombotic effects, and reduced risk of dementia are among these pleotropic effects. Statins have also been explored for its uses in life threatening diseases like cancer and inflammatory bowel disease. They have been demonstrated to revamp vascular tone. Many research and review articles have been thoroughly studied for this systematic review.

CONCLUSIONS

Statins have not only shown to be benefitial in lowering the levels of LDL-C but have also been established to be advantageous in the treatment of cancer, neurological conditions like dementia, multiple sclerosis, inflammatory bowel disease. Future high-quality trials are needed to include statins in the treatment of these conditions as per guidelines.

摘要

背景

除了降低循环中的低密度脂蛋白胆固醇(LDL-c)以及心血管疾病病例数和死亡率外,他汀类药物还具有辅助性的非脂质相关或非胆固醇依赖性作用,即多效性作用。本综述的目的是了解他汀类药物的多效性作用。

主体内容

心血管疾病(CVD)目前是全球非传染性疾病(NCDs)中导致患者痛苦和死亡的主要原因。尽管他汀类药物是全球范围内应用最广泛、处方最多且有循证依据的降脂药物,可降低低密度脂蛋白胆固醇(LDL-c)水平以及心血管疾病病例数和死亡人数,但他汀类药物还会引发辅助性的非脂质相关或非胆固醇依赖性作用,即多效性作用。这些多效性作用包括改善内皮功能、显著降低氧化应激、稳定动脉粥样硬化斑块、免疫调节、抑制血管平滑肌增殖、对骨代谢的影响、抗炎、抗血栓作用以及降低痴呆风险。他汀类药物还被探索用于治疗癌症和炎症性肠病等危及生命的疾病。它们已被证明可改善血管张力。为进行本系统综述,已对许多研究和综述文章进行了深入研究。

结论

他汀类药物不仅已被证明有助于降低LDL-C水平,还被证实对治疗癌症、痴呆、多发性硬化症等神经疾病以及炎症性肠病有益。未来需要高质量的试验,以便根据指南将他汀类药物纳入这些疾病的治疗中。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64e0/9816367/84ba4212efd5/43044_2023_327_Fig1_HTML.jpg

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