Effect of Fenofibrate on Lipoprotein Particles Predictive of Coronary Atherosclerosis

Abstract

Lipoprotein density classes and electrophoretic bands have been accepted as the fundamental physicochemical and metabolic entities of the lipid transport system (Gofman et al. 1954; Hatch and Lees 1968). This conceptual view has been used for the classification of the various dyslipoproteinemic states (Fredrickson et al. 1967). Recently, the discovery of several apolipoproteins, widely distributed throughout the density spectrum, with important structural and metabolic functions led to their use as specific markers for the classification of the lipoprotein species (Alaupovic et al. 1972; Alaupovic 1982). According to this view, the plasma lipoprotein system consists of a mixture of particles which may contain only one apolipoprotein (simple lipoprotein particles) or more than one apolipoprotein (complex lipoprotein particles). Changes in molecular structure can lead to variable expression of apolipoprotein epitopes. Using carefully selected monoclonal antibodies and newly developed immunological procedures we are now able to distinguish between atherogenic and non-atherogenic apo B-containing lipoprotein particles (Fievet et al. 1985; Fruchart et al. 1985c). These methods have been applied to a double-blind randomized study using fenofibrate in 37 type II_A hypercholesterolemic patients.