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Pharmacological control of lipid metabolism.
BOOK
REVIEW
P~rmacological Control of Lipid Metabolism. Edited by W. L. Holmes, R. Paoletti and D. Kritchevsky. iit ~.~P~~~~?~~~~cu~ ~~~d~c~~~ and ~~0~~~~~ Vol. 26 (1972). Plenum Press. New York. 359 pp. 526.00.
Adzmccs
This book contains the proceedings of the Fourth International Symposium on Drugs Affecting Lipid Metabolism, held in Philadelphia in September 1971. The text of most of the major contributions is included and there are 60 pages of abstracts. In spite of the general nature of the title. the subject matter of the book is concerned mostly with blood lipids, lipoproteins and atherosclerosis. Central to it are concepts of coping with disorders of lipoprotein metabolism which are considered important in the aetiology of atherosclerosis and its serious consequences. It is an intriguing thought that, while large numbers of pharmacologists are interested in the action of drugs on the lipid-rich membranes of tissues, there is also considerable interest in agents which alter levels of lipids in the blood stream. There is a link, since. as Hamilton points out in the first article in the book, there is a close relationship between membrane lipoproteins and nascent plasma lipoproteins. The book is divided into three main sections. The first section is concerned with present ideas on lipid and lipoprotein metabolism in relation to their plasma levels. Of particular significance is the chapter by Frederickson and his co-workers which deals with the classification and structure of the apolipoproteins, a rapidly developing subject of immense complexity. In addition, as Have1 notes, the determination of the role of lipoproteins in the transport of fat is yielding information about the pathogenesis of many hyperlipidaemic disorders and this may lead to their pharmacological control. ‘The second part of the book is largely concerned with drugs which alter the lipid and lipoprotein levels of the blood. Since all the blood lipids are bound in a lipoprotein form, any changes in lipid levels induced by drugs must reflect changes in lipoprotein. It is not therefore, a simple matter to decide what exactly a drug is doing and this point is well brought out in the contribution by Levy and Langer. There are interesting contributions in this section from Howard and his colleagues on clofibrate and hypercholesterolacmia and by Nikkila on drugs and plasma triglyceride metabolism, among others. The third section of the book is entitled, “Can heart disease be postponed or prevented?’ and commences with an anecdotal introduction by Page. All the contributions in this section are useful but there is a particularly fascinating account by Stamler and Berkson on what they call a multifactorial approach to the prevention of premature death from coronary heart disease. The implication that the epidemic can be controlled by changing life-style does not, however, obviate the necessity for research on therapy since changing life-style is a long-term project, to say the least. In summary. this book is an interesting source of information on the problems of blood hpoprotein metabolism, the dire consequences of its irregularities and the possibilities of therapeutic regulation. G. B. ANSELL
1095
REVIEW
P~rmacological Control of Lipid Metabolism. Edited by W. L. Holmes, R. Paoletti and D. Kritchevsky. iit ~.~P~~~~?~~~~cu~ ~~~d~c~~~ and ~~0~~~~~ Vol. 26 (1972). Plenum Press. New York. 359 pp. 526.00.
Adzmccs
This book contains the proceedings of the Fourth International Symposium on Drugs Affecting Lipid Metabolism, held in Philadelphia in September 1971. The text of most of the major contributions is included and there are 60 pages of abstracts. In spite of the general nature of the title. the subject matter of the book is concerned mostly with blood lipids, lipoproteins and atherosclerosis. Central to it are concepts of coping with disorders of lipoprotein metabolism which are considered important in the aetiology of atherosclerosis and its serious consequences. It is an intriguing thought that, while large numbers of pharmacologists are interested in the action of drugs on the lipid-rich membranes of tissues, there is also considerable interest in agents which alter levels of lipids in the blood stream. There is a link, since. as Hamilton points out in the first article in the book, there is a close relationship between membrane lipoproteins and nascent plasma lipoproteins. The book is divided into three main sections. The first section is concerned with present ideas on lipid and lipoprotein metabolism in relation to their plasma levels. Of particular significance is the chapter by Frederickson and his co-workers which deals with the classification and structure of the apolipoproteins, a rapidly developing subject of immense complexity. In addition, as Have1 notes, the determination of the role of lipoproteins in the transport of fat is yielding information about the pathogenesis of many hyperlipidaemic disorders and this may lead to their pharmacological control. ‘The second part of the book is largely concerned with drugs which alter the lipid and lipoprotein levels of the blood. Since all the blood lipids are bound in a lipoprotein form, any changes in lipid levels induced by drugs must reflect changes in lipoprotein. It is not therefore, a simple matter to decide what exactly a drug is doing and this point is well brought out in the contribution by Levy and Langer. There are interesting contributions in this section from Howard and his colleagues on clofibrate and hypercholesterolacmia and by Nikkila on drugs and plasma triglyceride metabolism, among others. The third section of the book is entitled, “Can heart disease be postponed or prevented?’ and commences with an anecdotal introduction by Page. All the contributions in this section are useful but there is a particularly fascinating account by Stamler and Berkson on what they call a multifactorial approach to the prevention of premature death from coronary heart disease. The implication that the epidemic can be controlled by changing life-style does not, however, obviate the necessity for research on therapy since changing life-style is a long-term project, to say the least. In summary. this book is an interesting source of information on the problems of blood hpoprotein metabolism, the dire consequences of its irregularities and the possibilities of therapeutic regulation. G. B. ANSELL
1095