血脂异常:药物治疗的叙述性综述

Dyslipidemia: A Narrative Review on Pharmacotherapy.

作者信息

de Oliveira Lucas Lentini Herling, de Assis Arthur Cicupira Rodrigues, Giraldez Viviane Zorzanelli Rocha, Scudeler Thiago Luis, Soares Paulo Rogério

机构信息

Instituto do Coração (InCor), Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av Dr Enéas de Carvalho Aguiar, 44, Cerqueira César 05403-000, Brazil.

出版信息

Pharmaceuticals (Basel). 2024 Feb 23;17(3):289. doi: 10.3390/ph17030289.

Abstract

Dyslipidemia plays a fundamental role in the development and progression of atherosclerosis. Current guidelines for treating dyslipidemia focus on low-density lipoprotein-cholesterol (LDL-C). Despite advances in the pharmacotherapy of atherosclerosis, the most successful agents used to treat this disease-statins-remain insufficient in the primary or secondary prevention of acute myocardial infarction. Advancing therapy for hypercholesterolemia with emerging new drugs, either as monotherapy or in combination, is expected to improve cardiovascular outcomes. An emerging field in dyslipidemia pharmacotherapy is research on genetic therapies and genetic modulation. Understanding the genetic mechanisms underlying lipid alterations may lead to the development of personalized treatments that directly target the genetic causes of dyslipidemia. RNA messenger (mRNA)-based therapies are also being explored, offering the ability to modulate gene expression to normalize lipid levels. Furthermore, nanotechnology raises new possibilities in drug delivery for treating dyslipidemia. Controlled-release systems, nanoparticles, and liposomes can enhance the effectiveness and safety of medications by providing more precise and sustained release. This narrative review summarizes current and emerging therapies for the management of patients with dyslipidemia.

摘要

血脂异常在动脉粥样硬化的发生和发展中起着重要作用。目前治疗血脂异常的指南主要关注低密度脂蛋白胆固醇(LDL-C)。尽管动脉粥样硬化药物治疗取得了进展,但用于治疗该疾病的最成功药物——他汀类药物——在急性心肌梗死的一级或二级预防中仍显不足。使用新型药物推进高胆固醇血症治疗,无论是单一疗法还是联合疗法,有望改善心血管结局。血脂异常药物治疗的一个新兴领域是基因治疗和基因调控研究。了解脂质改变背后的遗传机制可能会促成直接针对血脂异常遗传病因的个性化治疗的发展。基于信使核糖核酸(mRNA)的疗法也在探索中,它能够调节基因表达以使血脂水平正常化。此外,纳米技术为治疗血脂异常的药物递送带来了新的可能性。控释系统、纳米颗粒和脂质体可以通过提供更精确和持续的释放来提高药物的有效性和安全性。本叙述性综述总结了目前和新兴的血脂异常患者管理疗法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0895/10975559/8aa29b8dc21e/pharmaceuticals-17-00289-g001.jpg

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