Health Conditions

What is on the horizon?

As awareness of the health risks of too much fat and cholesterol in the body increases, the demand for medications that can lower levels of cholesterol and fats is expected to grow. Scientists continue to search for natural cholesterol-lowering substances. In addition to research on the efficacy of oat bran in reducing lipid levels in the blood, scientists have found evidence of cholesterol-lowering properties in various berries. In Israel, scientists are investigating the properties of a substance called glabridin, which is found in the roots of licorice and anise plants. This substance appears to inhibit the oxidation of LDL-cholesterol, which is a factor in the build-up of arterial plaque. The licorice or anise plant grows mainly in East Asian countries, including Mongolia and Vietnam. In these countries, chewing licorice root is a common practice and atherosclerosis is less common.

As in other medical fields, exciting research is exploring the genetic roots of hypercholesterolemia. With growing knowledge of both the chemistry of lipids in general, and cholesterol production in particular, scientists are unraveling the genes involved in lipid chemistry in the body. They are also studying genetic alterations that either protect individuals from hypercholesterolemia or make them more vulnerable. This kind of research may eventually yield medications that are even more effective than those that are currently in use and are more precisely targeted to the biochemistry of the condition.

Researchers have found, for example, that some patients do not respond to statins, the most widely used cholesterol medication. They believe that genetic variations appear to make some individuals more responsive and others less so. In the future, patients may be genetically assessed so that they can be prescribed the particular cholesterol-lowering medication that best fits their genetic profile.

In another recent paper, researchers in Sweden reported finding a gene variant that helps keep bad cholesterol at bay and may reduce heart disease risk by 50%. In a study of 184 healthy men, the research group found that a variation in gene that codes for the microsomal triglyceride transfer protein (MTP) was linked to low levels of LDL-cholesterol. The gene for MTP provides the blueprint for production of the protein that helps assemble LDL. Individuals who carry two copies of the variant form of the gene had LDL cholesterol levels 22% lower than did those who had one copy or no copies of the variant.

Although the MTP gene was first characterized in 1993, this is the first report of a common genetic variant within the gene. Individuals with the variant produce extra MTP, which results in reduced production of very-low-density lipoprotein (VLDL). Some drug companies have already begun looking at MTP inhibitors to help lower LDL.

In April 1999, Canadian scientists reported findings that give a clearer understanding of how HDL cholesterol helps prevent heart disease. The scientists found that a particular enzyme that is bound to HDL acts as a powerful antioxidant within blood vessels. This enzyme is called lecithin-cholesterol acetyltransferase (LCAT). While scientists are still studying exactly how LCAT prevents oxidation, they hope that in the future they may be able to enhance the antioxidant activity of LCAT in the body. In addition to its involvement in heart disease, oxidative damage is also thought to be a causative agent in the development of cancer.

In July 2003, researchers reported that they have identified a thyroid hormone kind of molecule that may be able to help people lose weight and lower cholesterol. The molecule that they have identified has been doing just that in laboratory animals. The hormone helps reduce weight by increasing the body's metabolic rate (the rate at which the body breaks down food and uses it for energy), which also helps keep blood cholesterol low. But thyroid hormone can also have potential dangerous side effects, the most worrisome of which is an increased heart rate. The aim of this research is to produce a drug that gives the benefits of thyroid hormone without the side effects. Their effort is based on the relatively new knowledge that there are two kinds of receptors that receive the hormone and pass its signal to the body. Researchers are now working to verify these findings.