PCSK 9, un nuevo blanco terapéutico para el control de la hipercolesterolemia

Roberto Antonio Fuentealba Leyton, Daniel Eduardo González

Resumen


La hipercolesterolemia es un importante factor de riesgo cardiovascular (ECV), que puede ser causada por factores genéticos, por llevar una vida sedentaria y malos hábitos alimenticios, teniendo como resultado elevados niveles de lípidos séricos, principalmente colesterol asociado a lipoproteínas de baja densidad (LDL-C). La dieta terapéutica, fármacos como ezetimiba y las estatinas son la principal estrategia utilizada para disminuir los niveles de LDL-C. Sin embargo, en un porcentaje de pacientes, estas medidas no logran una reducción de los niveles séricos LDL-C, principalmente por intolerancia a las estatinas o por causas genéticas de la hipercolesterolemia. La proproteína convertasa subtilisina/kexina tipo 9 (PCSK9), una serina proteasa recientemente caracterizada, ha surgido como un importante regulador del metabolismo del LDL-C, favoreciendo la degradación de su receptor (LDLR) en el lisosoma del hepatocito. Esto la convierte en un buen blanco terapéutico para controlar los niveles de LDL-C en pacientes hipercolesterolémicos, disminuyendo así el riesgo de desarrollar ECV. La estrategia en la que más se ha avanzado para controlar PCSK9 es a través de anticuerpos monoclonales anti-PCSK9. Se han realizado varios ensayos clínicos que muestran hasta el momento su efectividad en el control de LDL-C y bajo nivel de efectos adversos. Esta revisión muestra parte de esos estudios y los resultados que se han obtenido con el uso de este nuevo fármaco aún en desarrollo y que muestra un enorme potencial.


Palabras clave


Enfermedades Cardiovasculares; Proproteína Convertasa 9; anticuerpos; Receptores de LDL

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Referencias


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