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Emerging Lipoprotein-Related Therapeutics for Patients with Diabetes

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Lipoproteins in Diabetes Mellitus

Part of the book series: Contemporary Diabetes ((CDI))

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Abstract

Dyslipidemia manifesting as elevated LDL cholesterol and triglycerides, and low HDL cholesterol is the major hallmark of the factors leading to the development of atherosclerosis. Atherosclerosis develops over many years as a result of lipid deposition and inflammation in the walls of large arteries and its clinical manifestation is the rupture of plaques, interrupted blood flow, and consequential heart attacks and strokes. The metabolic milieu of diabetes, hyperglycemia, insulin resistance, and beyond accelerates the progression of atherosclerosis and enhances the occurrence of cardiovascular disease. It follows that those therapies which address dyslipidemia will have a favorable impact on the initiation and development of atherosclerosis. The HMGCoA reductase inhibitors (“statins”) have been the cornerstone of lipid-lowering therapy for several decades. However, these agents only lower cardiovascular events by 30%, so a considerable amount of disease occurs which is resistant to statins. Statins also have anti-inflammatory actions, and recent studies have shown that anti-inflammatory therapeutic strategies per se can reduce cardiovascular events even in people on statins. In this chapter, we address a multitude of new and some old but revitalized therapies, which target dyslipidemia and include a number of new biological based strategies which reflect the revolution occurring in the area of biological therapeutics as applied to this area of lipid-targeted strategies. There has been much recent progress and pharmaceutical development in this area. We describe recent changes in the conceptualization of atherosclerosis and present a number of new areas in which therapeutic agents are being developed to modulate plasma lipids and reduce atherosclerosis and cardiovascular disease. The specific agents presented are new and emerging agents acting on PCSK9, ATP citrate lyase inhibitors, omega-3 fatty acid products, and especially eicosapentaenoic ether and drugs targeting ApoC3 and angiopoietin-related protein 3.

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Authors and Affiliations

  1. Vascular Biology and Arteriosclerosis Laboratory, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Alex Bobik & Tin Kyaw

  2. Diabetes Centre, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Neale Cohen

  3. NHMRC Clinical Trials Centre, The University of Sydney, Sydney, NSW, Australia

    Alicia J. Jenkins

  4. Diabetes and Vascular Medicine, Baker Heart and Diabetes Institute, Melbourne, VIC, Australia

    Alicia J. Jenkins

  5. Department of Chemical Pathology, Royal Prince Alfred Hospital, NSW Health Pathology, Camperdown, NSW, Australia

    David Sullivan

  6. School of Pharmaceutical Sciences, Guangzhou Medical University, Guangzhou, People’s Republic of China

    Xiaoqian Wu

  7. Guangzhou Medical University, Guangzhou, People’s Republic of China

    Xi-Yong Yu

  8. School of Pharmacy, The University of Queensland, Woolloongabba, QLD, Australia

    Peter J. Little

Authors
  1. Alex Bobik
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  2. Neale Cohen
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  3. Alicia J. Jenkins
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  4. Tin Kyaw
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  5. David Sullivan
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  6. Xiaoqian Wu
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  7. Xi-Yong Yu
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  8. Peter J. Little
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Corresponding author

Correspondence to Peter J. Little .

Editor information

Editors and Affiliations

  1. NHMRC Clinical Trials Centre, University of Sydney, Sydney, NSW, Australia

    Alicia J. Jenkins

  2. Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Bobik, A. et al. (2023). Emerging Lipoprotein-Related Therapeutics for Patients with Diabetes. In: Jenkins, A.J., Toth, P.P. (eds) Lipoproteins in Diabetes Mellitus. Contemporary Diabetes. Humana, Cham. https://doi.org/10.1007/978-3-031-26681-2_30

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  • DOI: https://doi.org/10.1007/978-3-031-26681-2_30

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-031-26680-5

  • Online ISBN: 978-3-031-26681-2

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