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Fibrate Mechanism of Action - The Center for Cholesterol Management

Fibrate Mechanism of Action - The Center for Cholesterol Management

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<strong>Fibrate</strong>s and HDL Remodeling<br />

Drug induced HDL-C changes make no<br />

statement about RCT dynamics<br />

Apo A-I production<br />

Apo A-I gene<br />

expression<br />

SR-B1 gene<br />

expression<br />

Smaller<br />

alpha HDL<br />

Apo A-II gene<br />

expression<br />

PPAR<br />

LXR<br />

RXR<br />

ABC-1 gene<br />

expression<br />

CETP<br />

Nascent<br />

or pre-β<br />

<strong>Fibrate</strong>s HDL Apo increase A-II apoA-I and A-II production,<br />

upregulate production ABCA1 & lipidate HDL and<br />

upregulate hepatic SR-B1 & CETP and ultimately<br />

delipidate HDLs: Significant increase in HDL-P<br />

and modest increase in HDL-C<br />

ABCA-1<br />

production<br />

Maturing<br />

alpha HDL

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