Beneficial Effect of Omega-3 Fatty Acids on Sirolimus- or Everolimus-Induced Hypertriglyceridemia in Heart Transplant Recipients

Celik, Sultan; Doesch, Andreas O.; Erbel, Christian; Blessing, Erwin; Ammon, K.; Koch, Achim; Katus, Hugo A.; Dengler, Thomas J.

doi:10.1097/tp.0b013e318177281e

Cited by 40 publications

(22 citation statements)

References 44 publications

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“…A major concern with rapamycin therapy is that this drug induces hyperlipidemia in patients receiving at least 12 month treatment (Eisen et al. , 2003; Celik et al. , 2008).…”

Section: Discussionmentioning

confidence: 99%

Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels

Chen

Zhong

Zhang

et al. 2009

British J Pharmacology

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Background and purpose: Atherosclerotic plaque rupture and thrombosis are the main cause of acute coronary syndrome. The study was aimed to test the hypothesis that oral administration of rapamycin may attenuate inflammation, inhibit progression and enhance stability of atherosclerotic plaques. Experimental approach: Thirty New Zealand rabbits were subjected to balloon-induced endothelial injury of the abdominal aorta and were fed a diet of 1% cholesterol for 20 weeks. From week 9 to week 20, the animals were treated with oral rapamycin (0.5 mg·kg ; group B) and no drugs (group C). At the end of week 20, all rabbits were challenged with injection of Chinese Russell's viper venom and histamine. Serological, ultrasonographic, pathological, immunohistochemical and gene expression studies were performed. Key results: Rapamycin significantly increased the thickness of the fibrous caps and decreased plaque vulnerability index in group A rabbits. Serum lipid levels were higher whereas plaque burden was lower in group A than in group B (P < 0.05). The incidence of plaque rupture in group A (0%) and group B (0%) was significantly lower than that in group C (56.0%, P < 0.05). Conclusions and implications:Oral administration of rapamycin effectively attenuated inflammation, inhibited progression and enhanced stability of atherosclerotic plaques in rabbits, without altering serum lipid levels. Our findings suggest a novel approach to the treatment of atherosclerosis.

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“…A major concern with rapamycin therapy is that this drug induces hyperlipidemia in patients receiving at least 12 month treatment (Eisen et al. , 2003; Celik et al. , 2008).…”

Section: Discussionmentioning

confidence: 99%

Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels

Chen

Zhong

Zhang

et al. 2009

British J Pharmacology

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“…89,90 Hypertriglyceridemia (>500 mg/dl) is usually treated with gemfibrozil, though some centers use niacin or omega-3 fish oils 91 to avoid the additive risk of myopathy when using fibric acid derivatives with a statin. 77,92,93 Bile acid sequestrants should be avoided as they interfere with the enteral absorption of CNIs. 94 Diabetes Approximately 20% of KTRs have pre-transplant diabetes.…”

Section: Cigarette Smokingmentioning

confidence: 99%

Primary Care of the Renal Transplant Patient

et al. 2010

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There has been a remarkable rise in the number of kidney transplant recipients (KTR) in the US over the last decade. Increasing use of potent immunosuppressants, which are also potentially diabetogenic and atherogenic, can result in worsening of pre-existing medical conditions as well as development of post-transplant disease. This, coupled with improving long-term survival, is putting tremendous pressure on transplant centers that were not designed to deliver primary care to KTR. Thus, increasing numbers of KTR will present to their primary care physicians (PCP) post-transplant for routine medical care. Similar to native chronic kidney disease patients, KTRs are vulnerable to cardiovascular disease as well as a host of other problems including bone disease, infections and malignancies. Deaths related to complications of cardiovascular disease and malignancies account for 60-65% of long-term mortality among KTRs. Guidelines from the National Kidney Foundation and the European Best Practice Guidelines Expert Group on the management of hypertension, dyslipidemia, smoking, diabetes and bone disease should be incorporated into the long-term care plan of the KTR to improve outcomes. A number of transplant centers do not supply PCPs with protocols and guidelines, making the task of the PCP more difficult. Despite this, PCPs are expected to continue to provide general preventive medicine, vaccinations and management of chronic medical problems. In this narrative review, we examine the common medical problems seen in KTR from the PCP's perspective. Medical management issues related to immunosuppressive medications are also briefly discussed.

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“…Niacin should be considered in patients with elevations in both cholesterol and triglycerides. Omega-3 fatty acids have been successfully used to treat sirolimus-induced hypertriglyceridemia 49 and have been safely used in a variety of other settings. Omega-3 fatty acids reduce hepatic production of triglycerides and can reduce triglycerides by 35% to 45% at 4 g/day dosing.…”

Section: Management Of Dyslipidemia In the Hsct Patientmentioning

confidence: 99%

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

Griffith

Savani

Boord

2010

Blood

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Beneficial Effect of Omega-3 Fatty Acids on Sirolimus- or Everolimus-Induced Hypertriglyceridemia in Heart Transplant Recipients

Cited by 40 publications

References 44 publications

Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels

Oral rapamycin attenuates inflammation and enhances stability of atherosclerotic plaques in rabbits independent of serum lipid levels

Primary Care of the Renal Transplant Patient

Dyslipidemia after allogeneic hematopoietic stem cell transplantation: evaluation and management

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