Jim Edmond Leonard, Jim Edwin Leopold, Surya Reggie, Permatasari Happy Kurnia, Nurkolis Fahrul
Department of Cardiology and Vascular Medicine, Faculty of Medicine, Sam Ratulangi University, Manado 95115, Indonesia.
Department of Internal Medicine, Royal Taruma Hospital, Jakarta 11470, Indonesia.
Mar Drugs. 2025 Aug 12;23(8):325. doi: 10.3390/md23080325.
Atherosclerotic cardiovascular disease (ASCVD) remains a leading cause of morbidity and mortality worldwide, driven by dyslipidemia, chronic inflammation, oxidative stress, and endothelial dysfunction. Despite widespread use of lipid-lowering and anti-inflammatory agents such as statins, residual cardiovascular risk and adverse effects underscore the need for novel, safe, and multi-targeted therapies. Marine-derived polysaccharides (MDPs)-including fucoidan, alginate, laminarin, carrageenan, and chitosan-exhibit a spectrum of bioactivities relevant to ASCVD pathogenesis, such as anti-inflammatory, antioxidant, lipid-modulatory, antithrombotic, and endothelial-protective effects. In this critical review, we synthesize preclinical and emerging clinical evidence on the pharmacokinetics, mechanisms of action, and therapeutic potential of these compounds. We highlight translational challenges, including structural variability, poor oral bioavailability, and limited human data, and propose strategies to overcome these barriers, such as molecular standardization, novel delivery systems, and well-designed clinical trials. MDPs represent promising natural therapeutics for ASCVD prevention and treatment, warranting further investigation in rigorous human studies.
动脉粥样硬化性心血管疾病（ASCVD）仍然是全球发病和死亡的主要原因，由血脂异常、慢性炎症、氧化应激和内皮功能障碍驱动。尽管他汀类等降脂和抗炎药物广泛使用，但残余心血管风险和不良反应凸显了对新型、安全和多靶点疗法的需求。海洋来源的多糖（MDPs）——包括岩藻多糖、海藻酸盐、海带多糖、卡拉胶和壳聚糖——表现出一系列与ASCVD发病机制相关的生物活性，如抗炎、抗氧化、脂质调节、抗血栓和内皮保护作用。在这篇批判性综述中，我们综合了关于这些化合物的药代动力学、作用机制和治疗潜力的临床前和新出现的临床证据。我们强调了转化挑战，包括结构变异性、口服生物利用度差和人类数据有限，并提出了克服这些障碍的策略，如分子标准化、新型给药系统和精心设计的临床试验。MDPs是ASCVD预防和治疗有前景的天然疗法，值得在严格的人体研究中进一步研究。
