What role does the infection in the pathogenesis of coronary heart disease and coronary heart disease? Is it possible that inhibitors of cholesterol synthesis can not only reduce the level, but also to provide more and more important effect on the body of patients with coronary artery disease? Is it possible to systematize the inhibitors of cholesterol synthesis? Often there are patients with myocardial infarction who have not watched any of the classic risk factors for heart disease, especially in unstable angina. Furthermore, chlamydia is found in atherosclerotic plaques. Experimental studies have shown that chlamydia can infect in vitro cells are smooth muscle tissue and in vivo (in heart, which, however, is clearly not based on anti-infective properties of this class of drugs. Currently under large multicentre studies to clarify the pathogenetic significance infections. In particular, it is supposed to find out whether the infection stimulates additional atherosclerotic vascular changes, whether they are in the development of unstable angina or coronary syndromes, these vascular changes are only a consequence of the gap, because of which the atherosclerotic plaque is more vulnerable to infectious agents. However, these studies have not yet completed. Pending clarification of these issues antibiotics in patients with coronary heart disease can be treated only as a hypothesis based on experiments, and may not apply specifically to the practice. Perhaps only in patients with antibiotics can be considered as a last therapeutic option.
In each and every atherosclerotic lesions revealed inflammation, if we understand it as the activation of lymphocytes and macrophages. According to prof. Katus, inflammation should be seen as a crucial reaction in the pathogenesis of atherosclerosis. The anti-inflammatory response of endothelial cells, macrophages and smooth muscle cells of vessels in principle is nonspecific reaction of the local cells. It can be caused by various stimuli, such as viruses and bacteria, as well as cholesterol, LDL, endotoxins, and a number of diseases, such as diabetes mellitus. Studies show that cholesterol synthesis inhibitors should be considered as more than just a substance that reduce high cholesterol in plasma, they further develop anti-inflammatory effects and significantly reduce the adhesion of monocytes.
The number of infected cells decreased chlamydia, when the body contains cholesterol synthesis inhibitors (which showed, in particular, density and proliferation of smooth muscle cells. Unwanted side-effects depend on the total concentration of these drugs in the body and exposure to other factors. Thus, most of the known inhibitors of cholesterol synthesis and other active substances, such as cyclosporine and calcium channel blockers all are converted by the enzyme system CYP3A, which refers to a system of cytochrome P450. Cytochrome P450 system in its all subject to genetically determined differences in their activity. In addition, as it turned out, CYP3A enzyme system can be inhibited by taking macrolide antibiotics or, for example, simply use concentrated grapefruit juice. The total concentration in the body of inhibitors of cholesterol synthesis with high absorption and low bioavailability, the blockade of the enzyme system CYP3A, may rise by more than 10 for these statin while taking other drugs, it is sometimes necessary to reduce the concentration by titrating the dose to avoid undesirable side effects. In general, the spectrum of drug action these drugs quite favorable. Thus, experts have great hopes for inhibitors of cholesterol synthesis, as the drugs, developing a comprehensive anti-atherosclerotic action and look waiting for the results of ongoing studies to clarify the pathogenesis of many atherosclerotic plaques. Source: information-analytical portal 'Remedium.ru'.
