ABSTRACT
BACKGROUND:-There is evidence that ART is associated with lipodystrophy syndrome, a disturbance of lipid metabolism characterised by insulin resistance, dyslipidaemia, and fat maldistribution, metabolic bone disease (osteopenia and/or osteoporosis), and lactic acidosis. ART- associated dyslipidaemia is characterized by elevated serum concentrations of total cholesterol, triglycerides, low density lipoprotein 2(LDL-c), very low-density lipoprotein (VLDL), and Apo lipoprotein B (apoB) and low levels of high density lipoprotein (HDL-c) constituting an atherogenic lipid 1pro?le . In this study 143 young patients who were attending the Antiretroviral Therapy Plus MATERIAL AND METHODS:- Centre & Medicine Wards, ACSR GMC NELLORE were included randomly. 5ml Sample preparation and Biochemical assay :- of venous blood sample was collected by venipuncture from 12 hours overnight fast and centrifuged at 3000 cycles per minute and serum was separated for lipid pro?le measurement within one hour of blood collection. The serum levels of TC, HDL-C, LDL-C, VLDL and TG were measured using AU480 BECKMANS random access fully automated auto analyzer at Biochemistry laboratory, ACSR GMC, NELLORE. TC, LDL and TC/HDL lipid pro?les are signi?cant. F-Signi?cant values are RESULTS;- <0.05, reject null hypothesis. It means that the difference among the lipid pro?les of TC, LDL and TC/HDL in the study group is statistically signi?cant with respect to regimen groups. HDL, TG and VLDL lipid pro?les are not signi?cant. F-Signi?cant values are >0.05, no evidence to reject null hypothesis. It means that the no signi?cant difference among the lipid pro?les of HDL, TG, and VLDL in the study group is not statistically signi?cant with respect to regimen groups. Signi?cant CONCLUSIONS:- metabolic and morphological alterations occur in HIV infected patients especially in patients on HAART. The patients on HAART had an elevated Castelli Index I, indicating an increased risk for atherosclerotic cardiovascular disease in this population. There is need to assess lipid pro?les at baseline before initiation of HAART treatment and lipid pro?le monitoring during therapy to monitor any rising trends. New medications with more lipid friendly pro?les within existing drugs such as darunavir (PI), etravirine (NNRTI), new classes of drugs such as integrase inhibitors (raltegravir) and CCR5 inhibitors (maraviroc) can be used to avoid dyslipidaemia
ABSTRACT
Recent clinical trials and meta-analyses have indicated that high-intensive statin treatment lowers low-density lipoprotein cholesterol (LDL-C) levels and reduces the risk of nonfatal cardiovascular (CV) events compared with moderate-intensity statin treatment. However, there are residual risks of CV events and safety concerns associated with high-intensity statin treatment. The Improved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT) study showed that ezetimibe plus moderate-intensity statin therapy after acute coronary syndromes incrementally lowers LDL-C levels and improved CV outcomes compared with moderate-intensity statin therapy. However, despite the LDL-C-lowering effects, a substantial residual CV risk still remains, which includes other lipid abnormalities such as low high-density lipoprotein cholesterol (HDL-C). The most representative agents that primarily increase HDL-C are cholesteryl ester transfer protein (CETP) inhibitors. Until now, 4 CETP inhibitors, including torcetrapib, dalcetrapib, evacetrapib, and anacetrapib, have been introduced and all have significantly raised the HDL-C from 30% to 133%. However, the results for CV outcomes in clinical trials differed, based on the 4 agents. Torcetrapib increased the risk of CV events and total mortality in patients at high CV risk (ILLUMINATE trial). Dalcetrapib and evacetrapib did not result in lower rate of CV events in patients with recent acute coronary syndrome and high risk vascular disease, respectively (dal-OUTCOMES and ACCELERATE trials). However, anacetrapib significantly decreased the incidence of major coronary events in patients with atherosclerotic vascular disease (REVEAL trial). This topic summarizes the major results of recent statin and CETP inhibitor trials and provides framework to interpret and implement the trial results in real clinical practice.
Subject(s)
Humans , Acute Coronary Syndrome , Cholesterol , Cholesterol Ester Transfer Proteins , Dyslipidemias , Ezetimibe , Ezetimibe, Simvastatin Drug Combination , Hydroxymethylglutaryl-CoA Reductase Inhibitors , Incidence , Lipoproteins , Mortality , Vascular DiseasesABSTRACT
Atherosclerosis is an immune-mediated inflammatory disease of the arterial wall,with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens.Both proatherogenic as well as atheroprotective roles have been identified for the immune system in atherosclerosis.Hence,it is conceivable that an immuno-modulatory strategy via active immunization against many of these antigens could potentially alter the natural history of atherosclerosis.Cholesterol ester transfer protein (CETP) plays an important role in lipid metabolism,suggesting it might prevent atherosclerosis.This review discusses the recent advances of vaccine targeting the development of atherosclerosis,mainly about the CETP targeting vaccines.
ABSTRACT
Atherosclerosis is an immune-mediated inflammatory disease of the arterial wall, with both the innate and adaptive immune systems responding to many endogenous and exogenous antigens. Both proatherogenic as well as atheroprotective roles have been identified for the immune system in atherosclerosis. Hence, it is conceivable that an immuno-modulatory strategy via active immunization against many of these antigens could potentially alter the natural history of atherosclerosis. Cholesterol ester transfer protein (CETP) plays an important role in lipid metabolism, suggesting it might prevent atherosclerosis. This review discusses the recent advances of vaccine targeting the development of atherosclerosis, mainly about the CETP targeting vaccines.
ABSTRACT
The effect of cholesterol ester transfer protein(CETP) on SR-B1 mRNA expression in mouse liver was investigated.The results demonstrated that CETP transgenic mice showed lower serum total cholesterol and high density lipoprotein-cholesterol levels but higher total cholesterol and cholesterol ester content in liver when compared with wild type mice(P＜0.05).The expression of SR-B1 mRNA in liver of CETP transgenic mice was significantly lower as compared with the control group(P＜0.05).
ABSTRACT
Atherosclerosis (AS) is pathologically important basis of many kinds of coronary atherosclerosis disease (CAD). It can be substantially protected by raising high-density lipoprotein (HDL).In view of mechanism, drugs for raising HDL include: cholesterol ester transfer protein inhibitors, peroxisomal proliferator-activated receptor agonists, liver X-activated receptor agonists, farnesoid X receptor antagonists or agonists, lipoprotein lipase activators, niacin, and phenytoin and lecin : cholesterol acyltransferase activators, etc. This review aimed to the progress of drugs for regulating high-density lipoprotein and their mechanism, in view of clinical and preclinical aspects.
ABSTRACT
Objective To explore the relationship between plasma cholesterol ester transfer protein(CETP) and TaqIB gene polymorphism and type 2 diabetes mellitus(DM).Methods The genotypes of the first intron of CETP TaqIB gene in 102 patients with type 2 DM and 103 healthy controls were analyzed by polymerase chain reaction-restricted fragment length polymorphism(PCR-RFLP),and plasma CETP were measured by enzyme-linked immunosorbent assay(ELISA).The association of gene polymorphism with plasma lipids,lipoproteins and apolipoproteins was also analyzed.Results No significant differences in both of the alleles frequencies and genotypes in type 2 DM were noted in comparison with controls.There were no relationships between CETP TaqIB gene polymorphism and gender,family history,smoking and body mass index(BMI).No significant differences of plasma lipid levels were observed in healthy controls with different genotypes.However,significant differences in level of HDL-C or apoAI among different CETP TaqIB genotype groups were observed,and significant correlation between low high-density lipoproteinemia and B1 allele in type 2 DM was observed.Conclusion CETP TaqIB gene polymorphisms associated with lipid metabolism,which may be an important genetic factor for abnormal lipid metabolism in type 2 DM.