PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges

Hypercholesterolemia, is a prominent risk factor for cardiovascular disease (CVD). Undestanding of the biochemical mechanisms that regulate the expression of the low density lipoproteins receptor (LDLR) and the hepatic clearance of LDL cholesterol (LDL-C) paved the way to the statin therapy as the g...

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Main Authors: Norata, Giuseppe, Tibolla, G., Catapano, A.
Format: Journal Article
Published: 2014
Online Access:http://hdl.handle.net/20.500.11937/55532
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author Norata, Giuseppe
Tibolla, G.
Catapano, A.
author_facet Norata, Giuseppe
Tibolla, G.
Catapano, A.
author_sort Norata, Giuseppe
building Curtin Institutional Repository
collection Online Access
description Hypercholesterolemia, is a prominent risk factor for cardiovascular disease (CVD). Undestanding of the biochemical mechanisms that regulate the expression of the low density lipoproteins receptor (LDLR) and the hepatic clearance of LDL cholesterol (LDL-C) paved the way to the statin therapy as the gold standard for CVD prevention. The discovery of proteins that regulate - at a post-translational level - the activity of the LDLR has been a major breakthrough in developing new cholesterol-lowering drugs. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key modulator of the LDLR degradation in the liver. Genetic studies confirmed that in humans PCSK9 mutations associate with hypercholesterolemia and hypocholesterolemia (gain-of-function or loss-of-function variants respectively). Moreover, PCSK9 is up-regulated by statin treatment and limits the efficacy of these agents. These findings led to the development of PCSK9 inhibitors. Anti-PCSK9 monoclonal antibodies showed encouraging results and are currently being evaluated in phase III clinical trials. The aim of this short review is to describe the new frontier of PCSK9 inhibition in the treatment of hypercholesterolemia. Emphasis here is given to critical emerging issues linked to PCSK9 physiology and pharmacology, which will require future investigation to definitely address the potential of anti-PCSK9 drugs in clinical practice. © 2014 Elsevier Inc.
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spelling curtin-20.500.11937-555322017-09-13T16:11:24Z PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges Norata, Giuseppe Tibolla, G. Catapano, A. Hypercholesterolemia, is a prominent risk factor for cardiovascular disease (CVD). Undestanding of the biochemical mechanisms that regulate the expression of the low density lipoproteins receptor (LDLR) and the hepatic clearance of LDL cholesterol (LDL-C) paved the way to the statin therapy as the gold standard for CVD prevention. The discovery of proteins that regulate - at a post-translational level - the activity of the LDLR has been a major breakthrough in developing new cholesterol-lowering drugs. Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a key modulator of the LDLR degradation in the liver. Genetic studies confirmed that in humans PCSK9 mutations associate with hypercholesterolemia and hypocholesterolemia (gain-of-function or loss-of-function variants respectively). Moreover, PCSK9 is up-regulated by statin treatment and limits the efficacy of these agents. These findings led to the development of PCSK9 inhibitors. Anti-PCSK9 monoclonal antibodies showed encouraging results and are currently being evaluated in phase III clinical trials. The aim of this short review is to describe the new frontier of PCSK9 inhibition in the treatment of hypercholesterolemia. Emphasis here is given to critical emerging issues linked to PCSK9 physiology and pharmacology, which will require future investigation to definitely address the potential of anti-PCSK9 drugs in clinical practice. © 2014 Elsevier Inc. 2014 Journal Article http://hdl.handle.net/20.500.11937/55532 10.1016/j.vph.2014.05.011 restricted
spellingShingle Norata, Giuseppe
Tibolla, G.
Catapano, A.
PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title_full PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title_fullStr PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title_full_unstemmed PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title_short PCSK9 inhibition for the treatment of hypercholesterolemia: Promises and emerging challenges
title_sort pcsk9 inhibition for the treatment of hypercholesterolemia: promises and emerging challenges
url http://hdl.handle.net/20.500.11937/55532