51. Potential role of nonstatin cholesterol lowering agents.
- Author
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Trapani L, Segatto M, Ascenzi P, and Pallottini V
- Subjects
- Animals, Anticholesteremic Agents pharmacology, Cholesterol biosynthesis, Cholesterol blood, Clinical Trials as Topic, Farnesyl-Diphosphate Farnesyltransferase antagonists & inhibitors, Farnesyl-Diphosphate Farnesyltransferase metabolism, Humans, Hydroxymethylglutaryl-CoA Reductase Inhibitors pharmacology, Hydroxymethylglutaryl-CoA Reductase Inhibitors therapeutic use, Hypercholesterolemia enzymology, Intramolecular Transferases antagonists & inhibitors, Intramolecular Transferases metabolism, Molecular Targeted Therapy, Squalene Monooxygenase antagonists & inhibitors, Squalene Monooxygenase metabolism, Anticholesteremic Agents therapeutic use, Hypercholesterolemia drug therapy
- Abstract
Although statins, 3β-hydroxy-3β-methylglutaryl coenzyme A reductase (HMGR) inhibitors, have revolutionized the management of cardiovascular diseases by lowering serum low density lipoproteins, many patients suffer from their side effects. Whether the statin side effects are related to their intrinsic toxicity or to the decrease of HMGR main isoprenoid end products, which are essential compounds for cell viability, is still debated. In addition to HMGR, the key and rate limiting step of cholesterol synthesis, many enzymes are involved in this multi-step pathway whose inhibition could be taken into account for a "nonstatin approach" in the management of hypercholesterolemia. In particular, due to their unique position downstream from HMGR, the inhibition of squalene synthase, farnesyl diphosphate farnesyltransferase (FDFT1), squalene epoxidase (SQLE), and oxidosqualene cyclase:lanosterol synthase (OSC) should decrease plasma levels of cholesterol without affecting ubiquinone, dolichol, and isoprenoid metabolism. Thus, although FDFT1, SQLE and OSC are little studied, they should be considered as perspective targets for the development of novel drugs against hypercholesterolemia. Here, structure-function relationships of FDFT1, SQLE, and OSC are reviewed highlighting the advantages that the downstream inhibition of HMGR could provide when compared to the statin-based therapy., (Copyright © 2011 Wiley Periodicals, Inc.)
- Published
- 2011
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