Lowering serum lipids via PCSK9-targeting drugs: current advances and future perspectives.

Abstract:

:Proprotein convertase subtilisin/kexin type 9 (PCSK9), also known as neural apoptosis regulated convertase (NARC1), is a key modulator of cholesterol metabolism. PCSK9 increases the serum concentration of low-density lipoprotein cholesterol by escorting low-density lipoprotein receptors (LDLRs) from the membrane of hepatic cells into lysosomes, where the LDLRs are degraded. Owing to the importance of PCSK9 in lipid metabolism, considerable effort has been made over the past decade in developing drugs targeting PCSK9 to lower serum lipid levels. Nevertheless, some problems and challenges remain. In this review we first describes the structure and function of PCSK9 and its gene polymorphisms. We then discuss the various designs of pharmacological targets of PCSK9, including those that block the binding of PCSK9 to hepatic LDLRs (mimetic peptides, adnectins, and monoclonal antibodies), inhibit PCSK9 expression (the clustered regularly interspaced short palindromic repeats/Cas9 platform, small molecules, antisense oligonucleotides, and small interfering RNAs), and interfere with PCSK9 secretion. Finally, this review highlights future challenges in this field, including safety concerns associated with PCSK9 monoclonal antibodies, the limited utility of PCSK9 inhibitors in the central nervous system, and the cost-effectiveness of PCSK9 inhibitors.

journal_name

Acta Pharmacol Sin

authors

He NY,Li Q,Wu CY,Ren Z,Gao Y,Pan LH,Wang MM,Wen HY,Jiang ZS,Tang ZH,Liu LS

doi

10.1038/aps.2016.134

subject

Has Abstract

pub_date

2017-03-01 00:00:00

pages

301-311

issue

3

eissn

1671-4083

issn

1745-7254

pii

aps2016134

journal_volume

38

pub_type

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