Internal Medicine and Medical Investigation Journal

ISSN: 2474-7750

Pathophysiology of Dyslipidemia and Its Management by PCSK9 Inhibitors: A Literature Review

Abstract

Author(s): Tooba Adnan, Munazza Ahmad, Wardah M. Chaudhri, Ahsan Zil-E-Ali,Muhammad Umar Masood Gondal, Syed Muhammad Hammad Ali,Maira Nusrat,Saad Wasiq

Dyslipidemia is a disease of abnormal lipid levels in the blood that contributes to the

atherosclerotic process. This atherogenic process leads to the formation of plaque and also

leads to thromboembolic events and other vascular accidents. It is known that high-density

lipoprotein cholesterol serves as a protective effect on the vessel wall and causes the reduction

in the progression of atherosclerosis. And multiple interventions are directed in maintaining a

higher level of the aforementioned lipoprotein cholesterol. While the low-density lipoprotein

stays controversial but lowering its levels through various therapeutic agents is the main goal in

the management of dyslipidemia. A

newer group of drugs, proprotein convertase subtilisin/kexin

type 9 inhibitors lowers the levels of low-density lipoprotein through modulating proprotein

convertase subtilisin/kexin type

9 gene involved in cholesterol metabolism and affects the levels

of the lipoproteins by controlling the receptors. The inhibitors of this gene decrease proprotein

convertase subtilisin/kexin type 9-induced low-density lipoprotein receptor degradation in the

lysosomes of hepatocytes increasing its recfycling and expression on the cell surface, causing

increased clearance of low-density lipoprotein from the circulation. These drugs Alicuromab,

Evolocumab and along with other agents can be a novel approach in controlling dyslipidemic

state. This review revisits the literature in understanding the pathophysiology of dyslipidemia

along with its management by proprotein convertase subtilisin/kexin type

9 inhibitors, its

mechanism of action, its pharmacokinetics, the results of the clinical trials and the limitations in

its application.

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