Data di Pubblicazione:
1991
Citazione:
Mechanisms of lipid-lowering agents / C. R. Sirtori, C. Manzoni, M. R. Lovati. - In: CARDIOLOGY. - ISSN 0008-6312. - 78:3(1991), pp. 226-235. [10.1159/000174789]
Abstract:
Lipid-lowering agents are used with the purpose of ameliorating hyperlipoproteinemias, in order to prevent arterial disease. Lipid-lowering drugs can be classified into absorbable agents and into nonabsorbable compounds, acting within the gastrointestinal lumen. Absorbable drugs (fibric acids, nicotinic acid, probucol, HMG-CoA reductase inhibitors) reduce plasma very-low-density lipoproteins (VLDL) and/or low-density lipoproteins (LDL) by a variety of mechanisms. Fibric acids, in particular, act by stimulating the catabolism of VLDL and also, as a consequence, improving LDL delipidation, thus favoring receptor uptake. Nicotinic acid and acipimox interfere with the biosynthesis of LDL and can also improve the clearance of VLDL/LDL. Probucol acts by a newly described mechanism, i.e. accelerating reverse transport of cholesteryl esters from high-density lipoproteins to lower-density lipoproteins. Finally, HMG-CoA reductase inhibitors, interfering with the biosynthesis of cholesterol, can induce an increased expression of liver high-affinity lipoprotein receptors. Nonabsorbable agents (anion-exchange resins, neomycin, beta-sitosterol) interrupt the recirculation of bile acids and/or reduce the absorption of cholesterol with the gut. They display a selective activity on hypercholesterolemia, again by increasing LDL receptor expression. The choice of one or more lipid-lowering agents will depend upon the patient's phenotype, determining responsiveness to the pharmacological treatment.
Tipologia IRIS:
01 - Articolo su periodico
Keywords:
β-sitosterol; cholestyramine; colestipol; dextrothyroxine; fibric acid derivatives; HMG-CoA reductase inhibitors; metformin; neomycin; nicotinic acid; panthetine; probucol; tiadenol
Elenco autori:
C.R. Sirtori, C. Manzoni, M.R. Lovati
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