PCSK9在临床中的相关研究进展
Research Progress of PCSK9 in Clinical Practice
DOI: 10.12677/acm.2025.153605, PDF,   
作者: 胡艳丽, 周利珍, 张向凤, 杨婷婷：宁夏医科大学第一临床医学院，宁夏 银川；侯晓霖*：宁夏医科大学总医院神经内科，宁夏 银川
关键词: PCSK9；凋亡；铁下沉；自噬；PCSK9； Apoptosis； Iron Subsidence； Autophagy
摘要: 蛋白转化酶subtilisin/keexin type-9 (PCSK9)是一种通过与肝脏LDL受体(LDLR)结合来调节低密度脂蛋白(LDL)胆固醇代谢的蛋白，最终导致其溶酶体降解和低密度脂蛋白胆固醇水平升高。治疗策略基于特异性抗体阻断PCSK9 (Alirocumab, Evolocumab)和小调节RNA (siRNA)阻断其产生(Inclisiran)。临床试验评价这些药物在降低动脉粥样硬化性心血管疾病患者血清低密度脂蛋白水平和改善预后方面具有很高的疗效。大多数研究都集中在PCSK9对LDLRs的作用以及随后低密度脂蛋白浓度的增加。越来越多的证据表明，PCSK9对心血管的不良影响，特别是其对血管壁的动脉粥样硬化作用，也可能是由独立于其对脂质代谢影响的机制引起的。PCSK9诱导促炎细胞因子的表达，促进血管壁炎症，促进心肌细胞凋亡、铁下沉和自噬，从而参与心血管疾病的发生和进展。文章对PCSK9的结构、作用以及相关疾病方面的研究进行了综述，以期为未来的研究提供一个可能的研究思路和方向。
Abstract: Protein convertase subtilisin/keexin type-9 (PCSK9) is a protein that regulates low-density lipoprotein (LDL) cholesterol metabolism by binding to the hepatic LDL receptor (LDLR), ultimately leading to its lysosomal degradation and elevated LDL cholesterol levels. Treatment strategies are based on specific antibodies blocking PCSK9 (Alirocumab, Evolocumab) and small regulatory RNA (siRNA) blocking its production (Inclisiran). Clinical trials have evaluated the high efficacy of these drugs in reducing serum low-density lipoprotein levels and improving outcomes in patients with atherosclerotic cardiovascular disease. Most studies have focused on the effect of PCSK9 on LDLRs and the subsequent increase in LDL concentration. Accumulating evidence suggests that the adverse cardiovascular effects of PCSK9, particularly its atherosclerotic effects on the vessel wall, may also be caused by mechanisms independent of its effects on lipid metabolism. PCSK9 induces the expression of pro-inflammatory cytokines and promotes vascular wall inflammation, cardiomyocyte apoptosis, iron subsidence, and autophagy, thereby participating in the occurrence and progression of cardiovascular diseases. This article reviews the structure, function, and related diseases of PCSK9, in order to provide a possible research idea and direction for future research.
文章引用：胡艳丽, 周利珍, 张向凤, 杨婷婷, 侯晓霖. PCSK9在临床中的相关研究进展[J]. 临床医学进展, 2025, 15(3): 200-207. https://doi.org/10.12677/acm.2025.153605

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