History of lipidology and lipoprotein apheresis
History of lipidology and lipoprotein apheresis
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DOI：
10.1016/j.atherosclerosissup.2017.05.034
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发表时间：
2017-11-01
影响因子：
--
通讯作者：
Julius, Ulrich
中科院分区：
文献类型：
--
作者：
Julius, Ulrich
这篇综述讲述了20世纪初动脉粥样硬化研究的故事。它介绍了心血管疾病的重要性，并解决了目前在血脂专家中讨论的主要问题，以及目前关于低低密度脂蛋白-胆固醇水平和高密度脂蛋白的想法。它概述了引入调脂药物的时间及其与心血管结果数据的相关性，并列出了一些患者在接受他汀类药物治疗时发生新的心血管事件的可能原因。尤其令人印象深刻的是PCSK9抑制剂上市的历史--仅在PCSK9被检测到12年后；2017年完成的一项研究为这些新药的心血管效应提供了证据。其他新药也被提及：米帕莫森、洛米塔比特和阿利波根替帕沃韦克。一些有希望的药物仍在研发中，可以抑制载脂蛋白CIII、载脂蛋白(A)和PCSK9蛋白的合成。在20世纪70年代，特异性脂蛋白分离开始用于具有纯合子家族性高胆固醇血症、严重高胆固醇血症和脂蛋白(A)水平升高的高危患者，该综述为体外循环治疗在减少心血管事件方面的有效性提供了证据。特别是在高脂蛋白(A)水平的患者中，已被证明分离能够将心血管事件减少80%以上。本文描述了德国脂蛋白分离中心和患者的现状，最后对脂类治疗的未来选择进行了估计。(C)2017爱思唯尔B.V.保留所有权利。
This review tells the story of atherosclerosis research in the beginning of the 20th century. It presents the significance of cardiovascular diseases and addresses major questions currently being discussed among lipidologists and the current thinking with respect to low LDL-cholesterol levels and HDL. It provides an overview of the period during which lipid-modifying drugs were introduced and their relevance with respect to cardiovascular outcome data and lists possible reasons why some patients develop new cardiovascular events while being treated with statins. Especially impressive is the history of the appearance of the PCSK9 inhibitors on the market - only 12 years after PCSK9 was detected; a study completed in 2017 provides evidence about the cardiovascular effects of these new drugs. Other new drugs are also mentioned: mipomersen, lomitapide, and Alipogen Tiparvovec. Some promising drugs are still in the pipeline which inhibit the synthesis of apolipoprotein CIII, apolipoprotein(a), and the PCSK9 protein. During the 1970s, specific lipoprotein apheresis began to be used in high-risk patients with homozygous familial hypercholesterolemia, severe hypercholesterolemia and elevated Lipoprotein(a) levels and this review provides evidence of the effectiveness of the extracorporeal therapy with respect to the reduction of cardiovascular events. Particularly in patients with high Lipoprotein(a) levels, apheresis has been proven capable of reducing cardiovascular events by more than 80%. The current situation with regard to lipoprotein apheresis centers and patients in Germany is described herein, and, in conclusion, an estimation of the future of the therapeutic options in lipidology is given. (C) 2017 Elsevier B.V. All rights reserved.