AYURVEDIC HERBALS: EFFECTS ON LIPIDS & ATHEROSCLEROSIS

Philippe Szapary博士计划在宾夕法尼亚大学医学院担任临床研究员，专注于补充和替代医学(CAM)的关键评估。他的培训将包括临床流行病学理学硕士学位的正式课程工作，特别关注以患者为中心的研究(POR)。为了补充他的正式研究培训，他还计划在费城科学大学(USP)学习生药学和民族植物学课程。利用他在POR和植物药理学方面的正式培训，Szapary博士计划将自己确立为一名独立研究员，专注于新的和现有的心血管CAM疗法。环境：宾夕法尼亚大学和附近的USP非常适合为该奖项提供补充培训和资源。在宾夕法尼亚大学，临床流行病学和生物统计中心将提供正式的POR研究培训。心血管风险干预计划和普通内科将提供研究对象。综合临床研究中心将提供辅助支持，包括护士、一名营养师、一名生物统计程序员和实验室服务。在USP，生药学部门将在研究药物的分析方面提供技术支持。研究：在过去的10年里，患者显著增加了对膳食补充剂的使用，以治疗和预防动脉粥样硬化性心血管疾病等慢性疾病。尽管几乎没有科学证据表明从随机对照试验(RCT)中受益，但这种广泛的使用仍在继续。目前的估计显示，30%的美国人患有高胆固醇血症。血清胆固醇仍然是冠状动脉疾病风险的最强预测因素之一，冠状动脉疾病是美国人的主要死亡原因。草药疗法有多种作用机制，使其在预防动脉粥样硬化等多因素疾病过程中具有吸引力。阿育吠陀的两种草本植物，古里皮德和姜黄素，似乎对人类有降血脂、抗氧化和抗炎的作用。在该方案中，Szapary博士将在两个随机对照试验中主要研究姜黄素和葛根素的标准化提取物的降血脂作用。这些试验将评估这两种药物单独和联合使用时的安全性和有效性，就像在阿育吠陀药物中所做的那样，为期3到6个月。此外，萨帕里博士还将研究它们对氧化应激和血管微炎症等最先进生物标记物的影响，这两者都是动脉粥样硬化发病机制中的重要过程。这些研究将有助于确定这些草药疗法在预防动脉粥样硬化中的作用，并作为评价膳食补充剂在心血管疾病中的关键评估的模型。

Dr. Philippe Szapary plans a career as a clinician investigator at the University of Pennsylvania School of Medicine, focusing his research on the critical evaluation of complementary and alternative medicine (CAM). His training will include formal course work towards a Master's of Science in Clinical Epidemiology with a specific focus on patient-oriented research (POR). To supplement his formal research training, he also plans to take courses in pharmacognosy and ethnobotany at the University of the Sciences in Philadelphia (USP). Using his formal training in POR and botanical pharmacology, Dr. Szapary plans to establish himself as an independent investigator focusing on new and existing cardiovascular CAM therapies. Environment: The University of Pennsylvania and nearby USP are uniquely suited to provide complementary training and resources for this award. At Penn, the Center for Clinical Epidemiology and Biostatistics will provide the formal POR research training. The Cardiovascular Risk Intervention Program and the Division of General Internal Medicine will provide study subjects. The General Clinical Research Center will provide ancillary support including nurses, a dietitian, a biostatistical programmer and laboratory services. At USP, the Department of Pharmacognosy will provide technical support in the analysis of study drugs. Research: In the last 10 years, patients have markedly increased their use of dietary supplements to treat and prevent chronic medical conditions like atherosclerotic cardiovascular disease. This widespread use continues despite little scientific evidence of benefit from randomized controlled trials (RCTs). Current estimates suggest that 30 percent of Americans are hypercholesterolemic. Serum cholesterol remains one of the strongest predictors of risk for coronary artery disease, the leading cause of death in Americans. Herbal therapies have multiple mechanisms of action making them attractive in the prevention of a multifactorial disease process like atherosclerosis. Two Ayurvedic herbals, gugulipid and curcuminoids, appear to have hypolipidemic, antioxidant and anti- inflammatory effects in humans. In this protocol, Dr. Szapary will primarily study the hypolipidemic effects of standardized extracts of curcuminoids and gugulipid in two RCTs. These trials will assess the safety and efficacy of these two agents when used alone and in combination, as done in Ayurvedic medicine, over a 3 to 6 month period. In addition, Dr. Szapary will examine their effects on state of the art biomarkers of oxidant stress and vascular micro-inflammation, both of which are important processes in the pathogenesis of atherosclerosis. These studies will help define the role of these herbal therapies in the prevention of atherosclerosis, and serve as a model for the critical evaluation of dietary supplements in cardiovascular disease.