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，重点研究补充和替代医学（CAM）的关键评估。 他的培训将包括正式的课程工作对科学硕士临床流行病学与病人为导向的研究（POR）的具体重点。 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规培训，Szapary博士计划将自己确立为一名独立的研究者，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是唯一适合为这个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学中心将提供正式的POR研究培训。心血管风险干预项目和普通内科将提供研究受试者。 综合临床研究中心将提供辅助支持，包括护士、营养师、生物统计程序员和实验室服务。 在USP，生药学部门将为研究药物的分析提供技术支持。调研：在过去的10年里，患者明显增加了膳食补充剂的使用，以治疗和预防动脉粥样硬化性心血管疾病等慢性疾病。尽管随机对照试验（RCT）中几乎没有科学证据表明其有益，但这种广泛使用仍在继续。 目前的估计表明，30%的美国人患有高胆固醇血症。 血清胆固醇仍然是冠心病风险的最强预测因子之一，冠心病是美国人死亡的主要原因。 草药疗法具有多种作用机制，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。 两种阿育吠陀草药，gugulipid和姜黄素，似乎有降血脂，抗氧化和抗炎作用的人类。 在本方案中，Szapary博士将在两项RCT中主要研究姜黄素和gugulipid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使用和联合使用时的安全性和有效性，如在阿育吠陀医学中所做的那样，为期3至6个月。 此外，Szapary博士将研究它们对氧化应激和血管微炎症的最新生物标志物的影响，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，并作为心血管疾病膳食补充剂关键评估的模型。

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.