血管生成素样蛋白:心血管生物学及预防心血管疾病的治疗靶点

Angiopoietin-Like Proteins: Cardiovascular Biology and Therapeutic Targeting for the Prevention of Cardiovascular Diseases.

作者信息

Thorin Eric, Labbé Pauline, Lambert Mélanie, Mury Pauline, Dagher Olina, Miquel Géraldine, Thorin-Trescases Nathalie

机构信息

Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Department of Pharmacology, Université de Montréal, Montréal, Québec, Canada; Faculty of Medicine, Department of Surgery, Université de Montréal, Montréal, Québec, Canada.

Montreal Heart Institute, Université de Montréal, Montréal, Québec, Canada.

出版信息

Can J Cardiol. 2023 Dec;39(12):1736-1756. doi: 10.1016/j.cjca.2023.06.002. Epub 2023 Jun 7.

Abstract

Despite the best pharmacologic tools available, cardiovascular diseases (CVDs) remain a major cause of morbidity and mortality in developed countries. After 2 decades of research, new therapeutic targets, such as angiopoietin-like proteins (ANGPTLs), are emerging. ANGPTLs belong to a family of 8 members, from ANGPTL1 to ANGPTL8; they have structural homology with angiopoietins and are secreted in the circulation. ANGPTLs display a multitude of physiological and pathologic functions; they contribute to inflammation, angiogenesis, cell death, senescence, hematopoiesis, and play a role in repair, maintenance, and tissue homeostasis. ANGPTLs-particularly the triad ANGPTL3, 4, and 8-have an established role in lipid metabolism through the regulation of triacylglycerol trafficking according to the nutritional status. Some ANGPTLs also contribute to glucose metabolism. Therefore, dysregulation in ANGPTL expression associated with abnormal circulating levels are linked to a plethora of CVD and metabolic disorders including atherosclerosis, heart diseases, diabetes, but also obesity and cancers. Because ANGPTLs bind to different receptors according to the cell type, antagonists are therapeutically inadequate. Recently, direct inhibitors of ANGPTLs, mainly ANGPTL3, have been developed, and specific monoclonal antibodies and antisense oligonucleotides are currently being tested in clinical trials. The aim of the current review is to provide an up-to-date preclinical and clinical overview on the function of the 8 members of the ANGPTL family in the cardiovascular system, their contribution to CVD, and the therapeutic potential of manipulating some of them.

摘要

尽管有现有的最佳药物工具,但心血管疾病(CVDs)仍是发达国家发病和死亡的主要原因。经过20年的研究,新的治疗靶点正在出现,如血管生成素样蛋白(ANGPTLs)。ANGPTLs属于一个由8个成员组成的家族,从ANGPTL1到ANGPTL8;它们与血管生成素具有结构同源性,并在循环中分泌。ANGPTLs具有多种生理和病理功能;它们参与炎症、血管生成、细胞死亡、衰老、造血,并在修复、维持和组织稳态中发挥作用。ANGPTLs——特别是ANGPTL3、4和8三联体——通过根据营养状况调节三酰甘油转运在脂质代谢中发挥既定作用。一些ANGPTLs也参与葡萄糖代谢。因此,与异常循环水平相关的ANGPTL表达失调与多种心血管疾病和代谢紊乱有关,包括动脉粥样硬化、心脏病、糖尿病,还有肥胖和癌症。由于ANGPTLs根据细胞类型与不同的受体结合,拮抗剂在治疗上并不充分。最近,已经开发出了ANGPTLs的直接抑制剂,主要是ANGPTL3,并且特异性单克隆抗体和反义寡核苷酸目前正在临床试验中进行测试。本综述的目的是提供关于ANGPTL家族8个成员在心血管系统中的功能、它们对心血管疾病的贡献以及操纵其中一些成员的治疗潜力的最新临床前和临床概述。

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