我们是否需要预防动脉粥样硬化的疫苗?我们能否很快得到疫苗?

IF 5.7 2区 医学 Q1 PERIPHERAL VASCULAR DISEASE Current Atherosclerosis Reports Pub Date : 2024-03-01 Epub Date: 2024-01-02 DOI:10.1007/s11883-023-01186-z
Stanisław Surma, Amirhossein Sahebkar, Maciej Banach
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引用次数: 0

摘要

审查目的:动脉粥样硬化性心血管疾病(ASCVD)是导致过早死亡的主要原因。血脂紊乱,尤其是血清低密度脂蛋白胆固醇(LDL-C)升高,是导致动脉粥样硬化性心血管疾病的重要原因。患上 ASCVD 的风险受暴露于 LDL-C 浓度升高的持续时间(胆固醇年概念)的影响。根据 "越早越好"、"越低越好 "和 "越长越好 "的原则实施降脂治疗已被证明可降低心血管风险并显著延长寿命。尽管降脂药物种类繁多,但要达到令人满意的控制血脂紊乱的效果仍然非常具有挑战性。因此,需要采用新方法来提高治疗的依从性:目前正在研究的一个很有前景的解决方案是开发一种抗 PCSK9 疫苗,每年注射一次,可长期控制低密度脂蛋白胆固醇的浓度。实验研究和迄今为止进行的唯一一项临床试验表明,抗 PCSK9 疫苗能诱导与降脂和抗动脉粥样硬化作用相关的持久免疫反应。此外,它还表现出良好的耐受性和令人满意的安全性。然而,我们仍需要二期、三期和心血管结果试验的数据来证实其安全性和有效性,并为现有和未来的降脂药物库增添价值。本文强调了开发抗 PCSK9 疫苗的意义,并概述了目前有关各种抗 PCSK9 疫苗的知识。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Whether and Why Do We Need a Vaccine Against Atherosclerosis? Can We Expect It Anytime Soon?

Purpose of review: Atherosclerotic cardiovascular disease (ASCVD) is a leading cause of premature death. Lipid disorders, particularly elevated serum low-density lipoprotein cholesterol (LDL-C), contribute significantly to ASCVD. The risk of developing ASCVD is influenced by the duration of exposure to elevated LDL-C concentrations (cholesterol-years concept). Implementing lipid-lowering treatments based on the principles of "the earlier the better," "the lower the better," and "the longer the better" has been shown to reduce cardiovascular risk and significantly extend lifespan. Despite the availability of numerous lipid-lowering drugs, achieving satisfactory control of lipid disorders remains very challenging. Therefore, there is a need for novel approaches to improve treatment adherence.

Recent findings: One promising solution under investigation is the development of an anti-PCSK9 vaccine, which could be administered annually to provide long-term control over LDL-C concentrations. Experimental studies and the sole clinical trial conducted thus far have demonstrated that the anti-PCSK9 vaccine induces a durable immune response associated with lipid-lowering and anti-atherosclerotic effects. Furthermore, it has exhibited good tolerability and a satisfactory safety profile. However, we still need data from phase 2, 3, and cardiovascular outcome trial to confirm its safety and efficacy and add value in the armamentarium of available and perspective lipid-lowering drugs. This article highlights the significance of developing an anti-PCSK9 vaccine and provides an overview of the current knowledge on various anti-PCSK9 vaccines.

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来源期刊
CiteScore
9.00
自引率
3.40%
发文量
87
审稿时长
6-12 weeks
期刊介绍: The aim of this journal is to systematically provide expert views on current basic science and clinical advances in the field of atherosclerosis and highlight the most important developments likely to transform the field of cardiovascular prevention, diagnosis, and treatment. We accomplish this aim by appointing major authorities to serve as Section Editors who select leading experts from around the world to provide definitive reviews on key topics and papers published in the past year. We also provide supplementary reviews and commentaries from well-known figures in the field. An Editorial Board of internationally diverse members suggests topics of special interest to their country/region and ensures that topics are current and include emerging research.
期刊最新文献
Myopathy in Statin-Treated Children and Adolescents: A Practical Approach. "Improving Diet Quality of Children with Dyslipidemia Who also Exhibit Picky Eating Behaviors". Transitioning Adolescents and Young Adults with Lipid Disorders to Adult Health Care. PCSK9 Monoclonal Antibodies Have Come a Long Way. Pericoronary Fat Attenuation: Diagnosis and Clinical Implications.
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