Lipids in Health and Disease
Lipids in Health and Disease
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DOI：
10.1007/978-1-4020-8831-5
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发表时间：
2008
影响因子：
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通讯作者：
U. N. Das;Allam A Rao
中科院分区：
文献类型：
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作者：
U. N. Das;Allam A Rao
降低血浆低密度脂蛋白-胆固醇（LDL-C）、血压、同型半胱氨酸，并使用他汀类药物、三种降压药物（如噻嗪类、β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂，每种药物的标准剂量为一半）、叶酸和阿司匹林（称为聚吡唑）联合预防血小板聚集，估计可将心血管事件减少约80%。必需脂肪酸（EFA）及其长链代谢产物：γ-亚麻酸（GLA）、二高-GLA（DGLA）、花生四烯酸、二十碳五烯酸（EPA）和二十二碳六烯酸（DHA）以及其它产物如前列腺素E1（PGE 1）、前列环素（PGI 2）、PGI 3、脂氧素（LX）、消退素、包括神经保护素D1（NPD 1）的保护素防止血小板聚集、降低血压、具有抗炎作用，降低LDL-C，改善同型半胱氨酸的不利作用，显示抗炎作用，激活端粒酶，并具有细胞保护特性。因此，EFA及其代谢物显示出“复方片剂”预期的所有经典作用。与所提出的“复方制剂”不同，EFA是存在于几乎所有组织中的内源性分子，没有显著或很少的副作用，甚至孕妇、哺乳期母亲以及婴儿、儿童和成人也可以长期口服;并且已知其可以降低心血管疾病包括中风的发病率。此外，各种EFA及其长链代谢产物不仅能促进一氧化氮的生成，还能与一氧化氮反应生成各自的硝基烯烃衍生物，这些硝基烯烃衍生物可产生血管舒张作用，抑制中性粒细胞脱粒和超氧化物形成，抑制血小板活化，并具有PPAR-γ配体活性和释放NO，从而预防血小板聚集、血栓形成、动脉粥样硬化和心血管疾病。基于这些证据，我建议ω-3和ω-6脂肪酸及其适当作用/代谢所必需的辅因子的合理组合与他汀类药物、噻嗪类药物、β受体阻滞剂和血管紧张素转换酶（ACE）抑制剂、叶酸和阿司匹林的联合使用一样有益。此外，ω-3脂肪酸和ω-6脂肪酸的适当组合甚至可以以保护免受抑郁症、精神分裂症、阿尔茨海默病的形式显示出额外的益处，并增强认知功能;并用作内源性抗炎分子;并且可以从童年开始终身施用。发表日期：2008年10月15日健康和疾病中的脂质2008，7：37 doi：10.1186/1476- 511 X-7-37接收：2008年9月30日接受：2008年10月15日这篇文章可从：http://www.lipidworld.com/content/7/1/37 © 2008 Das; licensee BioMed Central Ltd.这是一个开放获取的文章根据知识共享署名许可证的条款分发（http：//creativecommons.org/licenses/by/2.0），允许在任何媒体上不受限制地使用、分发和复制，前提是适当引用原始作品。
Lowering plasma low density lipoprotein-cholesterol (LDL-C), blood pressure, homocysteine, and preventing platelet aggregation using a combination of a statin, three blood pressure lowering drugs such as a thiazide, a β blocker, and an angiotensin converting enzyme (ACE) inhibitor each at half standard dose; folic acid; and aspirin-called as polypillwas estimated to reduce cardiovascular events by ~80%. Essential fatty acids (EFAs) and their long-chain metabolites: γ-linolenic acid (GLA), dihomo-GLA (DGLA), arachidonic acid, eicosapentaenoic acid (EPA), and docosahexaenoic acid (DHA) and other products such as prostaglandins E1 (PGE1), prostacyclin (PGI2), PGI3, lipoxins (LXs), resolvins, protectins including neuroprotectin D1 (NPD1) prevent platelet aggregation, lower blood pressure, have anti-arrhythmic action, reduce LDL-C, ameliorate the adverse actions of homocysteine, show anti-inflammatory actions, activate telomerase, and have cytoprotective properties. Thus, EFAs and their metabolites show all the classic actions expected of the "polypill". Unlike the proposed "polypill", EFAs are endogenous molecules present in almost all tissues, have no significant or few side effects, can be taken orally for long periods of time even by pregnant women, lactating mothers, and infants, children, and adults; and have been known to reduce the incidence cardiovascular diseases including stroke. In addition, various EFAs and their long-chain metabolites not only enhance nitric oxide generation but also react with nitric oxide to yield their respective nitroalkene derivatives that produce vascular relaxation, inhibit neutrophil degranulation and superoxide formation, inhibit platelet activation, and possess PPAR-γ ligand activity and release NO, thus prevent platelet aggregation, thrombus formation, atherosclerosis, and cardiovascular diseases. Based on these evidences, I propose that a rational combination of ω-3 and ω-6 fatty acids and the co-factors that are necessary for their appropriate action/metabolism is as beneficial as that of the combined use of a statin, thiazide, a β blocker, and an angiotensin converting enzyme (ACE) inhibitor, folic acid, and aspirin. Furthermore, appropriate combination of ω-3 and ω-6 fatty acids may even show additional benefits in the form of protection from depression, schizophrenia, Alzheimer's disease, and enhances cognitive function; and serve as endogenous anti-inflammatory molecules; and could be administered from childhood for life long. Published: 15 October 2008 Lipids in Health and Disease 2008, 7:37 doi:10.1186/1476-511X-7-37 Received: 30 September 2008 Accepted: 15 October 2008 This article is available from: http://www.lipidworld.com/content/7/1/37 © 2008 Das; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.