Heart Disease: Is cholesterol really the problem



Cholesterol Build-Up May Be to Blame for Macular Degeneration

Aging cells lose their ability to clear cholesterol deposits in the eye, which may be to blame for macular degeneration, according to a new study, which also finds that statin drugs may help prevent the problem.

By Amir Khan

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WEDNESDAY, April 3, 2013 —  One of the most common causes of blindness in older Americans, age-related macular degeneration, may be the result of cholesterol build-up in the eye, said researchers in a report published in the journal Cell Metabolism. They also identified a drug that has potential to treat the problem.

Cholesterol build-up in the eye occurs because cells known as macrophages that act as mini garbage disposals to remove "trash" from the eye lose this ability as they age, which can lead to cholesterol build-up and allow the excess blood vessel growth that causes age-related macular degeneration, or AMD.

"Ideally, macrophages should take up cholesterol, process it, and spit it out into the bloodstream,” said Rajendra Apte, MD, PhD, study coauthor and professor of ophthalmology and vision sciences at Washington University in St. Louis, in a statement. “In AMD, we think the cells are ingesting cholesterol but not able to spit it out. So you get these inflamed macrophages that promote blood vessel growth."

Working in mice and human cells, researchers from the National Eye Institute found that this breakdown of macrophages is the result of a deficiency in the protein ABCA1, researchers said, which is needed for macrophages to clear cholesterol deposits and release them into the bloodstream. When the researchers deleted the protein ABCA1 from young macrophages, they began to act like older macrophages and lost their ability to remove cholesterol.

Restoring the macrophage’s ABCA1 allowed the cells to resume their duties, researchers said.

"We were able to deliver the drug, called an LXR agonist, in eye drops, and we found that we could reverse the macular degeneration in the eye of an old mouse,” Abdoulaye Sene, PhD, study coauthor and a post-doctoral fellow at the Washington University School of Medicine, said in a statement. “That's exciting because if we could use eye drops to deliver drugs that fight macular degeneration, we could focus therapy only on the eyes, and we likely could limit the side effects of drugs taken orally.”

There is currently no way to reverse the damage of macular degeneration, but treatment focuses on stopping blood vessel growth in people in the intermediate, but not early, stages of the disease. The most commonly prescribed drugs for the condition are Lucentis and Eylea, but the National Eye Institute also recommends people with macular degeneration take vitamin and zinc supplements.

However, improving the ability of macrophages to remove cholesterol  could potentially stop progression of the disease by helping halt blood vessel growth, researchers said.

"If we could prevent the blood vessels from growing, it would be better than trying to eliminate them after the fact," Dr. Apte said in the statement.

While having high blood cholesterol levels has not been linked to developing macular degeneration, Apte said the next step is to see whether statins and other cholesterol-lowering medications could help treat AMD.

"Based on our findings, we need to investigate whether vision loss caused by macular degeneration could be prevented with cholesterol-lowering eye drops or other medications that might prevent the buildup of lipids beneath the retina," he said.






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Date: 01.12.2018, 06:24 / Views: 73531