Enhancing reverse cholesterol transport: the case for phosphatidylcholine therapy.
Enhancing reverse cholesterol transport: the case for phosphatidylcholine therapy.
复制标题
增强反向胆固醇转运：磷脂酰胆碱治疗的案例。
DOI：
10.1097/01.mol.0000169345.15450.4b
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发表时间：
2005
影响因子：
4.4
通讯作者：
Ehnholm,Christian
中科院分区：
文献类型：
--
作者：
Pownall,HenryJ;Ehnholm,Christian
在1975年的一篇社论中，Charles Day写道：“只有一种药物在一种或多种动物物种中证明了逆转实验性动脉粥样硬化的能力：卵磷脂（磷脂酰胆碱）。Day博士列举了磷脂酰胆碱治疗的障碍，包括成本、纯度、毒性和稳定性，这些都已经得到了解决。口服与静脉给药的途径仍然存在问题，前者更安全，更低的交付成本，并减少患者的负担。另一个问题是，一种依赖于输注磷脂酰胆碱（一种天然产品）的疗法不能是专有的，因此制药公司的兴趣会很低。根据最近的研究，越来越多的人相信可以考虑输注磷脂酰胆碱治疗，特别是对于常规治疗不可选的高危患者，例如急性冠状动脉综合征、家族性高胆固醇血症或孤立性低HDL胆固醇。因此，未来的计划，磷脂酰胆碱治疗，其中可能包括磷脂酰胆碱微乳剂或HDL重建apoA-I和磷脂酰胆碱（rHDL）的输注，或添加磷脂酰胆碱现有的脂蛋白，必须重新审查的背景下，目前已知的HDL代谢。
In a 1975 editorial, Charles Day wrote ‘only one agent has demonstrated the ability to reverse experimental atherosclerosis in one or more animal species: lecithin (phosphatidylcholine)’[1]. Dr Day cited barriers to phosphatidylcholine therapy that included cost, purity, toxicity, and stability, which have since been addressed. The route of administration, oral versus intravenous, remains problematical, with the former preferred because of greater safety, lower delivery cost, and reduced patient burden. Another concern was that a therapy that depends on the infusion of phosphatidylcholine, a natural product, could not be proprietary so that interest from pharmaceutical companies would be low. In light of recent studies, there is growing confidence that therapies involving the infusion of phosphatidylcholine might be considered, particularly for high-risk patients for whom conventional therapy is not an option, eg in acute coronary syndrome, familial hypercholesterolemia, or isolated low HDL-cholesterol. Therefore, future plans for phosphatidylcholine therapy, which might include the infusions of phosphatidylcholine microemulsions or HDL reconstituted from apoA-I and phosphatidylcholine (rHDL), or the addition of phosphatidylcholine to existing lipoproteins, must be re-examined within the context of what is currently known about HDL metabolism.