摘要
心血管疾病是全球死亡的主要原因。动脉粥样硬化是CVD的主要病因,是一种慢性免疫炎症性疾病,具有复杂的多因素病理生理,包括氧化应激、免疫炎症级联增强、内皮功能障碍和血栓形成。动脉粥样硬化的初始事件是内皮下低密度脂蛋白(LDL)的积累,随后巨噬细胞定位于血管壁上的脂肪沉积物,形成富含脂质的巨噬细胞(泡沫细胞),分泌参与斑块形成的化合物。鉴于泡沫细胞是动脉粥样硬化病理生理的关键罪魁祸首之一,因此研究人员特别关注如何有效地治疗巨噬细胞胆固醇代谢失调,减少泡沫细胞的形成和/或迫使其降解。前蛋白转化酶枯草溶菌9 (PCSK9)是一种分泌性丝氨酸蛋白酶,已成为脂质代谢途径的重要调节因子。PCSK9的激活导致LDL受体(LDLR)的降解,增加循环中的LDL胆固醇(LDL-C)水平。PCSK9通路失调已被确定为动脉粥样硬化的机制之一。此外,研究人员还研究了microRNAs (miRNAs)作为动脉粥样硬化病理生理和脂质代谢失调的重要表观遗传因素。本文综述了PCSK9在动脉粥样硬化中的作用以及各种miRNA参与调控PCSK9相关基因表达的最新发现。我们还讨论了基于PCSK9抑制的PCSK9通路靶向治疗干预,以及治疗剂对miRNA水平的操纵。
关键词: 动脉粥样硬化、心血管疾病、血脂异常、miRNA、PCSK9、治疗干预、基因编辑。
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