Yoshida H, Suzukawa M, Ishikawa T, Shige H, Nishio E, Hosoai H, Ayaori M, Nakamura H
1st Department of Internal Medicine, National Defense Medical College, Saitma, Japan.
Cardiovasc Drugs Ther. 1996 Mar;10(1):67-74. doi: 10.1007/BF00051132.
Previous reports, based on clinical trials and animal experiments, suggest that beta-blockers may be useful in the prevention of atherosclerosis. Betaxolol, a new beta1-selective blocker, was shown to decrease plasma total and LDL cholesterol levels or to have no adverse effect on those [1-4]. While many reports deal with metabolism of triglyceride and high density lipoprotein, fewer publications about cholesterol metabolism are currently available. To clarify the mechanism by which beta-blockers affect lipid metabolism, we examined the effects of beta-blockers on HMG CoA reductase and LDL receptor activity in cultured human skin fibroblasts. L-propranolol, a nonselective beta-blocker, increased HMG CoA reductase activity and decreased LDL receptor activity. However, d-propranolol had no major effects on HMG CoA reductase activity. These results suggest that beta-blockers act on HMG CoA reductase through the beta receptors. Beta1-blocking action should decrease HMG CoA reductase activity and increase LDL receptor activity. In fact, betaxolol, a beta1-selective blocker, decreased HMG CoA reductase activity and increased LDL receptor activity, but metoprolol had no major effect. We speculate that the discrepancy between betaxolol and metoprolol in the effect on HMG CoA reductase and the LDL receptor might be due to the difference of the extent of beta1-selectivity. We conclude that beta1-selective blockers are antihypertensive agents potentially valuable in the prevention of atherosclerosis.
以往基于临床试验和动物实验的报告表明,β受体阻滞剂可能有助于预防动脉粥样硬化。倍他洛尔是一种新型的β1选择性阻滞剂,已显示可降低血浆总胆固醇和低密度脂蛋白胆固醇水平,或对这些指标无不良影响[1-4]。虽然许多报告涉及甘油三酯和高密度脂蛋白的代谢,但目前关于胆固醇代谢的出版物较少。为了阐明β受体阻滞剂影响脂质代谢的机制,我们研究了β受体阻滞剂对培养的人皮肤成纤维细胞中HMG CoA还原酶和低密度脂蛋白受体活性的影响。非选择性β受体阻滞剂L-普萘洛尔增加了HMG CoA还原酶活性,降低了低密度脂蛋白受体活性。然而,d-普萘洛尔对HMG CoA还原酶活性没有重大影响。这些结果表明,β受体阻滞剂通过β受体作用于HMG CoA还原酶。β1阻断作用应降低HMG CoA还原酶活性并增加低密度脂蛋白受体活性。事实上,β1选择性阻滞剂倍他洛尔降低了HMG CoA还原酶活性并增加了低密度脂蛋白受体活性,但美托洛尔没有重大影响。我们推测,倍他洛尔和美托洛尔在对HMG CoA还原酶和低密度脂蛋白受体的影响上存在差异,可能是由于β1选择性程度的不同。我们得出结论,β1选择性阻滞剂是预防动脉粥样硬化具有潜在价值的抗高血压药物。