Illingworth D R
Department of Medicine, Oregon Health Sciences University, Portland 97201-3098.
J Nutr Sci Vitaminol (Tokyo). 1993;39 Suppl:S43-7. doi: 10.3177/jnsv.39.supplement_s43.
Hypercholesterolemia attributable to increased plasma concentrations of low density lipoproteins is a well recognized risk factor for the premature development of coronary atherosclerosis in both experimental animals and humans. Recent studies have indicated that modifications to low density lipoprotein result in enhanced uptake of the modified lipoproteins by macrophages and lead to accelerated rates of lipid deposition and the creation of foam cells. Oxidation of low density lipoprotein has been shown to be one of the modifications which leads to uptake of this lipoprotein by scavenger receptors present on macrophages and results in intracellular lipid accumulation. Treatment of hypercholesterolemic animals with antioxidant drugs, including probucol, has been shown to reduce the development of atherosclerosis and xanthoma regression has been observed in patients with severe hypercholesterolemia treated with this drug. Epidemiologic studies support the view that low plasma concentrations of antioxidant vitamins, including vitamin E are associated with higher rates of coronary atherosclerosis in humans and that supplementation with vitamin E is associated with a decreased incidence of coronary artery disease. Prospective clinical trials to assess the potential benefit of antioxidant supplementation in high risk patients are currently in progress and these trials, when completed, should provide definitive information concerning the potential benefits to be derived from supplementation with antioxidant vitamins as an adjunctive therapy to prevent the premature development of atherosclerosis.
血浆中低密度脂蛋白浓度升高所致的高胆固醇血症，是实验动物和人类冠状动脉粥样硬化过早发生的一个公认危险因素。最近的研究表明，低密度脂蛋白的修饰会导致巨噬细胞对修饰后的脂蛋白摄取增加，并导致脂质沉积加速和泡沫细胞形成。低密度脂蛋白的氧化已被证明是导致巨噬细胞上的清道夫受体摄取这种脂蛋白并导致细胞内脂质积累的修饰之一。用抗氧化药物（包括普罗布考）治疗高胆固醇血症动物，已被证明可减少动脉粥样硬化的发展，并且在用该药物治疗的严重高胆固醇血症患者中观察到了黄色瘤消退。流行病学研究支持这样的观点，即包括维生素E在内的抗氧化维生素血浆浓度低与人类冠状动脉粥样硬化发生率较高相关，而补充维生素E与冠心病发病率降低相关。目前正在进行前瞻性临床试验，以评估在高危患者中补充抗氧化剂的潜在益处，这些试验完成后，应能提供有关补充抗氧化维生素作为辅助治疗预防动脉粥样硬化过早发生的潜在益处的确切信息。
