Medical School, University of Western Australia, Perth, Australia.
Department of Cardiology and Internal Medicine, Royal Perth Hospital, Perth, Australia.
Curr Atheroscler Rep. 2024 Nov 20;27(1):6. doi: 10.1007/s11883-024-01254-y.
PURPOSE OF REVIEW: Dyslipidemia is a casual risk factor for atherosclerotic cardiovascular disease (ASCVD). There is an unmet need for more effective treatments for patients with dyslipidemias. Angiopoietin-like protein 3 (ANGPTL3) and ANGPTL8 play key roles in triglyceride trafficking and energy balance in humans. We review the functional role of these ANGPTL proteins in the regulation of lipoprotein metabolism, and recent clinical trials targeting ANGPTL3 and ANGPTL3/8 with monoclonal antibody and/or nucleic acid therapies, including antisense oligonucleotides and small interfering RNA. RECENT FINDINGS: Cumulative evidence supports the roles of ANGPTL3 and ANGPTL8 in lipid metabolism through inhibition of lipoprotein lipase and endothelial lipase activity. ANGPTL3 and ANGPTL3/8 inhibitors are effective in lowering plasma triglycerides and low-density lipoprotein (LDL)-cholesterol, with the possible advantage of raising high-density lipoprotein (HDL)-cholesterol with the inhibition of ANGPTL3/8. Therapeutic inhibition of ANGPTL3 and ANGPTL3/8 can lower plasma triglyceride and LDL-cholesterol levels possibly by lowering production and upregulating catabolism of triglyceride-rich lipoprotein and LDL particles. However, the effect of these novel agents on HDL metabolism remains unclear. The cardiovascular benefits of ANGPTL3 and ABGPTL3/8 inhibitors may also include improvement in vascular inflammation, but this requires further investigation.
目的综述:血脂异常是动脉粥样硬化性心血管疾病(ASCVD)的一个偶然危险因素。血脂异常患者需要更有效的治疗方法,但目前仍存在未满足的需求。血管生成素样蛋白 3(ANGPTL3)和 ANGPTL8 在人类甘油三酯转运和能量平衡中发挥关键作用。我们综述了这些 ANGPTL 蛋白在调节脂蛋白代谢中的功能作用,以及最近针对 ANGPTL3 和 ANGPTL3/8 的单克隆抗体和/或核酸治疗(包括反义寡核苷酸和小干扰 RNA)的临床试验。
最新发现:越来越多的证据表明,ANGPTL3 和 ANGPTL8 通过抑制脂蛋白脂肪酶和内皮脂肪酶的活性在脂质代谢中发挥作用。ANGPTL3 和 ANGPTL3/8 抑制剂可有效降低血浆甘油三酯和低密度脂蛋白(LDL)-胆固醇水平,其可能通过抑制 ANGPTL3/8 升高高密度脂蛋白(HDL)-胆固醇。ANGPTL3 和 ANGPTL3/8 的治疗性抑制可能通过降低甘油三酯丰富的脂蛋白和 LDL 颗粒的产生和上调其代谢来降低血浆甘油三酯和 LDL-胆固醇水平。然而,这些新型药物对 HDL 代谢的影响尚不清楚。ANGPTL3 和 ANGPTL3/8 抑制剂的心血管益处可能还包括改善血管炎症,但这需要进一步研究。
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