College of Pharmaceutical Science, Zhejiang University of Technology, Hangzhou 310014, P.R. China.
Curr Med Chem. 2024;31(9):1082-1106. doi: 10.2174/0929867330666230202111849.
Familial hypercholesterolemia (FH) is an autosomal dominant inheritable disease with severe disorders of lipid metabolism. It is mainly marked by increasing levels of plasma total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), xanthoma, corneal arch, and early-onset coronary heart disease (CHD). The prevalence of FH is high, and it is dangerous and clinically underdiagnosed. The clinical treatment for FH includes both pharmacological and non-pharmacological treatment, of which non-pharmacological treatment mainly includes therapeutic lifestyle change and dietary therapy, LDL apheresis, liver transplantation and gene therapy. In recent years, many novel drugs have been developed to treat FH more effectively. In addition, the continuous maturity of non-pharmacological treatment techniques has also brought more hope for the treatment of FH. This paper analyzes the pathogenic mechanism and the progress in clinical treatment of FH. Furthermore, it also summarizes the mechanism and structure-activity relationship of FH therapeutic drugs that have been marketed. In a word, this article provides a reference value for the research and development of FH therapeutic drugs.
家族性高胆固醇血症(FH)是一种常染色体显性遗传性疾病,具有严重的脂质代谢紊乱。其主要特征为血浆总胆固醇(TC)和低密度脂蛋白胆固醇(LDL-C)水平升高、黄色瘤、角膜弓和早发冠心病(CHD)。FH 的患病率较高,且具有危险性和临床漏诊率高的特点。FH 的临床治疗包括药物治疗和非药物治疗,其中非药物治疗主要包括治疗性生活方式改变和饮食疗法、LDL 吸附、肝移植和基因治疗。近年来,已经开发出许多新型药物来更有效地治疗 FH。此外,非药物治疗技术的不断成熟也为 FH 的治疗带来了更多希望。本文分析了 FH 的发病机制和临床治疗进展,并总结了已上市的 FH 治疗药物的作用机制和构效关系。总之,本文为 FH 治疗药物的研究和开发提供了参考价值。