PCSK9抑制剂在动脉粥样硬化(Atherosclerosis, AS)疾病中的预防和影响作用
Prevention and Influence of PCSK9 Inhibitors in Atherosclerotic (AS) Diseases
摘要: 动脉粥样硬化(AS)是众多血管性疾病的前期病理基础,受累动脉病变多开始于内膜,逐渐使动脉壁变硬变厚,失去弹性直至缺血、纤维化。PCSK9抑制剂(proprotein convertase subtilisin-kexin type 9 inhibitors)可通过降低low-density lipoprotein cholesterol (LDL-C)而逆转及减小动脉斑块的大小和体积,减轻血管壁的炎症,调节血管内皮功能,增加纤维帽的厚度及稳定性等多方面作用从而对AS疾病起到积极的预防作用。本文将系统阐述PCSK9抑制剂对AS疾病的进展及治疗中发挥的作用。
Abstract: Atherosclerosis (AS) is the pre-pathological basis of many vascular diseases. The affected arteries usually start from the intima, and gradually make the arterial wall hard and thick, lose its elasticity, until ischemia and fibrosis. PCSK9 inhibitors (proprotein convertase subtilisin-kexin type 9 inhibitors) can reverse and reduce the size and volume of arterial plaques by lowering LDL-C, reducing inflammation of blood vessel walls, regulating vascular endothelial function, and increasing the thickness and stability of the fibrous cap. It plays a positive role in the prevention of AS disease. This article will systematically describe the role of PCSK9 inhibitors in the progression and treatment of AS disease.
文章引用:王秀玲, 耿强, 吴倩倩, 王正忠. PCSK9抑制剂在动脉粥样硬化(Atherosclerosis, AS)疾病中的预防和影响作用[J]. 临床医学进展, 2021, 11(12): 5735-5739. https://doi.org/10.12677/ACM.2021.1112848

参考文献

[1] Norata, G.D., Ballantyne, C.M. and Catapano, A.L. (2013) New Therapeutic Principles in Dyslipidaemia: Focus on LDL and Lp(a) Lowering Drugs. European Heart Journal, 34, 1783-1789. [Google Scholar] [CrossRef] [PubMed]
[2] Reiner, Z., Catapano, A.L., De Backer, G., et al. (2011) ESC/EAS Guidelines for the Management of Dyslipidaemias: The Task Force for the Management of Dyslipidaemias of the European Society of Cardiology (ESC) and the European Atherosclerosis Society (EAS). European Heart Journal, 32, 1769-1818. [Google Scholar] [CrossRef] [PubMed]
[3] 廖玉华, 程翔. 非HDL-C与动脉粥样硬化性心血管病[J]. 临床心血管病杂志, 2014, 30(9): 743-745.
[4] Gistera, A. and Ketelhuth, D.F.J. (2018) Lipid-Driven Immunometabolic Responses in Atherosclerosis. Current Opinion in Lipidology, 29, 375-380. [Google Scholar] [CrossRef
[5] 梁春. 强化降脂和抗炎“双达标”防治动脉粥样硬化性心血管疾病: 虚拟还是现实? [J]. 临床心血管病杂志, 2019, 35(9): 775-776.
[6] Back, M., Yurdagul, A., Tabas, I., et al. (2019) Inflammation and Its Resolution in Atherosclerosis: Mediators and Therapeutic Opportunities. Nature Reviews Cardiology, 16, 389-406. [Google Scholar] [CrossRef] [PubMed]
[7] Collins, R., Reith, C., Emberson, J., Armitage, J., et al. (2016) Interpretation of the Evidence for the Efficacy and Safety of Statin Therapy. The Lancet, 388, 2532-2561. [Google Scholar] [CrossRef
[8] Lloyd-Jones, D.M., Morris, P.B., Ballantyne, C.M., Birtcher, K.K., Daly, D.D., DePalma, S.M., Minissian, M.B., Orringer, C.E. and Smith, S.C. (2017) Focused Update of the 2016 ACC Expert Consensus Decision Pathway on the Role of Nonstatin Therapies for LDL-Cholesterol Lowering in the Management of Atherosclerotic Cardiovascular Disease Risk: A Report of the American College of Cardiology Task Force on Clinical Expert Consensus Documents. Journal of the American College of Cardiology, 68, 92-125. [Google Scholar] [CrossRef] [PubMed]
[9] Tang, Z.H., Peng, J., Ren, Z., et al. (2017) New Role of PCSK9 in Atherosclerotic Inflammation Promotion Involving the TLR4/NF-kB Pathway. Atherosclerosis, 262, 113-122. [Google Scholar] [CrossRef] [PubMed]
[10] Amato, M., Veglia, F., de Faire, U., et al. (2017) Carotid Plague-Thickness and Common Carotid IMT Show Additive Value in Cardiovascular Risk Prediction and Reclassification. Atherosclerosis, 263, 412-419. [Google Scholar] [CrossRef] [PubMed]
[11] Bonetti, P.O., Lerman, L.O. and Lerman, A. (2003) Endothelial Dysfunction: A Marker of Atherosclerotic Risk. Arteriosclerosis, Thrombosis, and Vascular Biology, 23, 168-175. [Google Scholar] [CrossRef
[12] Poredos, P., KekLjubec, A., Poredos, P. and Visnovic Poredos, A. (2006) Endothelial Dysfunction Predictor of Structural Changes of Arterial Wall in Type I Diabetes. International Angiology, 25, 280-286.
[13] Cavieres, V., Valdes, K., Moreno, B., Moore-Carrasco, R. and Gonzalez, D.R. (2014) Vascular Hypercontractility and Endothelial Dysfunction before Development of Atherosclerosis in Moderate Dyslipidemia: Role for Nitric Oxide and Interleukin-6. American Journal of Cardiovascular Disease, 4, 114-122.
[14] Makimattila, S. and Yki-Jarvinen, H. (2002) Endothelial Dysfunction in Human Diabetes. Current Diabetes Reports, 2, 26-36. [Google Scholar] [CrossRef] [PubMed]
[15] Nevelsteen, I., Van den Bergh, A., Van der Mieren, G., et al. (2013) NO-Dependent Endothelial Dysfunction in Type II Diabetes Is Aggravated by Dyslipidemia and Hypertension, But Can Be Restored by Angiotensin-Converting Enzyme Inhibition and Weight Loss. Journal of Vascular Research, 50, 486-497. [Google Scholar] [CrossRef] [PubMed]
[16] Mihos, C.G., Pieda, A.M. and Santana, O. (2014) Cardiovascular Effects of Statins, beyond Lipid-Lowering Properties. Pharmacological Research, 88, 12-19. [Google Scholar] [CrossRef] [PubMed]
[17] Tesfamariam, B. (2006) The Effects of HMG-CoA Reductase Inhibitors on Endothelial Function. American Journal of Cardiovascular Drugs, 6, 115-120. [Google Scholar] [CrossRef] [PubMed]