A Randomised Trial Of The Effects Of Cholesterol Lowering Therapy Among Patients With Chronic Renal Impairment
Funder
National Health and Medical Research Council
Funding Amount
$333,250.00
Summary
People with kidney disease are well known to be at high risk of developing major health problems earlier in life than people without kidney problems. In particular, people with kidney disease are more likely to suffer from heart attacks and strokes. For a number of other high-risk patient groups (such as people with heart disease), studies have clearly shown that cholesterol-lowering treatment can significantly reduce the risks of serious complications. However, until now, patients with kidney d ....People with kidney disease are well known to be at high risk of developing major health problems earlier in life than people without kidney problems. In particular, people with kidney disease are more likely to suffer from heart attacks and strokes. For a number of other high-risk patient groups (such as people with heart disease), studies have clearly shown that cholesterol-lowering treatment can significantly reduce the risks of serious complications. However, until now, patients with kidney disease have generally been excluded from such studies because of concerns about drug side effects. New, better-tolerated cholesterol lowering drugs now offer an opportunity to see if this highly effective treatment is also protective among people with kidney disease. The HARP (Heart And Renal Protection) trial is a large new study that will be done as a collaboration between Australian researchers and researchers from the University of Oxford in the UK. The aim of the study is to see if low doses of two cholesterol-lowering drugs can reduce the risks of stroke and heart attack. The study will include about 9,000 people with chronic kidney disease followed for an average of 4 years. It is hoped that by using low doses of two treatments, rather than a high dose of one, it will be possible to get substantial benefits without side effects. There are presently many tens of thousands of individual in Australia with chronic kidney disease and many millions of such individuals worldwide. The results of the HARP study will therefore influence the care of a very large number of people. If the results were positive, implementation of this new treatment would be expected to prevent many tens of thousands of premature strokes and heart attacks around the world each year.Read moreRead less
MECHANISTIC ROLE OF CHOLESTEROL IN NON-ALCOHOLIC STEATOHEPATITIS
Funder
National Health and Medical Research Council
Funding Amount
$533,541.00
Summary
Fatty liver is present in 15-30% of Australians, related to obesity, diabetes and heart attack. Two-thirds of cases reverse easily. The remainder evolve to non-alcoholic steatohepatitis (NASH), liver damage that can lead to cirrhosis and liver failure. This research seeks to find out why some cases of fatty liver lead to NASH, and whether cholesterol that accumulates in the livers of mice with NASH is what causes that damage. If so, we will find new ways to treat NASH by diet or drugs.
Vascular Effects Of Exercise Training And Lipid-lowering Therapy At Rest And During Exercise In Hypercholesterolaemia
Funder
National Health and Medical Research Council
Funding Amount
$241,650.00
Summary
The health of the cells which line blood vessels, endothelial cells, is now known to be important in maintaining normal function of the circulation. In patients with elevated blood cholesterol concentration, the function of these cells is abnormal and this is considered to contribute importantly to the blood vessel dysfunction and cardiovascular disease seen in this condition. We have recently demonstrated that drug therapy aimed at decreasing cholesterol concentration in the blood can significa ....The health of the cells which line blood vessels, endothelial cells, is now known to be important in maintaining normal function of the circulation. In patients with elevated blood cholesterol concentration, the function of these cells is abnormal and this is considered to contribute importantly to the blood vessel dysfunction and cardiovascular disease seen in this condition. We have recently demonstrated that drug therapy aimed at decreasing cholesterol concentration in the blood can significantly improve blood vessel function. In other studies we have demonstrated that exercise training improves blood vessel function. The purpose of this research is to determine whether high blood cholesterol impairs exercise capacity by limiting blood flow to exercising muscle. It is also our goal to determine whether exercise training can produce benefit additional to that resulting from lowering cholesterol in those with initially high cholesterol. Blood vessel function will be studied at rest, in response to pharmacological stimulation and during exercise. Vascular function in the forearm will be assessed using synchronised ultrasound (high frequency sound, sonar) and Doppler measures which assess the size of, and flow in, the large artery near the elbow crease. During measurements, procedures are undertaken to alter flow in the arm blood vessels, some depending upon functional ability of the endothelial cells and some independent of those cells. In addition to assessment of blood vessel function, measurements of exercise tolerance will be taken before and after each intervention. By examining the effects of lipid-lowering and exercise training on rest and exercise blood flow responses, this research will help determine the best approach to improving blood vessel function and cardiovascular fitness in patients with high cholesterol.Read moreRead less
Characterising An Important Control Point In Cholesterol Synthesis Beyond HMG-CoA Reductase
Funder
National Health and Medical Research Council
Funding Amount
$480,739.00
Summary
The statins are the ‘go-to’ drugs for treating heart disease; blocking a very early, highly-controlled step in the pathway producing cholesterol. However, they inhibit the production of other vital molecules which explains why some patients do not tolerate them. We have identified that a later enzyme in this pathway is also highly controlled and here aim to characterise the molecular mechanisms involved. This work could translate into the development of even safer drugs for treating cholesterol- ....The statins are the ‘go-to’ drugs for treating heart disease; blocking a very early, highly-controlled step in the pathway producing cholesterol. However, they inhibit the production of other vital molecules which explains why some patients do not tolerate them. We have identified that a later enzyme in this pathway is also highly controlled and here aim to characterise the molecular mechanisms involved. This work could translate into the development of even safer drugs for treating cholesterol-related diseases.Read moreRead less
Our goal is to discover new mechanisms involved in our cells’ delicate balancing act with respect to cholesterol levels. Understanding how production of cholesterol is controlled in our cells is key to developing new drugs aimed at preventing its excessive accumulation. This will have long-term benefits for health considering that a cellular imbalance in cholesterol is involved in two of the most common conditions threatening the health of Australians, namely heart disease and Alzheimer’s diseas ....Our goal is to discover new mechanisms involved in our cells’ delicate balancing act with respect to cholesterol levels. Understanding how production of cholesterol is controlled in our cells is key to developing new drugs aimed at preventing its excessive accumulation. This will have long-term benefits for health considering that a cellular imbalance in cholesterol is involved in two of the most common conditions threatening the health of Australians, namely heart disease and Alzheimer’s disease.Read moreRead less
Improving Patient Outcomes In Familial Hypercholesterolaemia Across The Continuum Of Care
Funder
National Health and Medical Research Council
Funding Amount
$645,205.00
Summary
'Familial' means it runs in families and 'hypercholesterolaemia' means high blood cholesterol. Familial Hypercholesterolaemia (FH) is the most common and serious form of inherited high cholesterol. People with FH are at an increased risk of developing cardiovascular disease. High cholesterol also placed an estimated $4 billion burden on the Australian economy in 2017-18. Practical research on prevention strategies will improve cardiovascular health outcomes and lower the burden of health costs.
The Blood Pressure Lowering Treatment Trialists' Collaboration
Funder
National Health and Medical Research Council
Funding Amount
$166,250.00
Summary
Treatments that lower blood pressure are well known to reduce the risk of heart attack and stroke, and several different classes of blood pressure lowering drug are now widely used. While all the main classes of drug offer protection against serious complications, it is possible that one drug class may be better than the others. However, whether this is so remains uncertain and cannot be reliably determined by any one single study. The Blood Pressure Lowering Treatment Trialists' Collaboration i ....Treatments that lower blood pressure are well known to reduce the risk of heart attack and stroke, and several different classes of blood pressure lowering drug are now widely used. While all the main classes of drug offer protection against serious complications, it is possible that one drug class may be better than the others. However, whether this is so remains uncertain and cannot be reliably determined by any one single study. The Blood Pressure Lowering Treatment Trialists' Collaboration is a large international project led by a group of Australian researchers based at the Institute for International Health in Sydney. The aim of the project is to systematically gather together sufficient information from large-scale studies to make it possible to answer important outstanding questions about the effects of different classes of blood pressure lowering drugs on major outcomes, such as heart attack and stroke. The Collaboration includes many of the leading blood pressure researchers from around the world and will combine data from more than 30 trials and over 200,000 individuals. On the basis of the overview results it should be possible to provide doctors with important new information about the best blood pressure lowering treatment for their patients. A previous review of the effects of blood pressure drugs completed by the same group was published in The Lancet in 2000, and has been an important aid to many professional and regulatory groups in the year since. Reliable information about the effects of different classes of blood pressure lowering drugs is of great importance. Even if differences between the effects of different classes of drug are small, the implications for the prevention of blood pressure-related complications would be substantial because of the very large numbers of people taking them, worldwide. This collaborative overview project offers a unique opportunity to provide the most reliable and up-to-date information on the subject.Read moreRead less
Modulation Of Cell Phospholipids And Membranes By 7-ketocholesterol And Their Role In Cholesterol Efflux.
Funder
National Health and Medical Research Council
Funding Amount
$186,372.00
Summary
Atherosclerosis is a leading cause of death in Australia. The disease is caused by the formation of large deposits of cholesterol in the walls of major blood vessels. This cholesterol comes from cholesterol-carrying particles in the blood which penetrate into the tissue of the blood vessel. They are taken up by the cells of the tissue which become engorged with large amounts of cholesterol and are called 'foam cells'. These foam cells also contain a small but signficant amount of damaged (oxidis ....Atherosclerosis is a leading cause of death in Australia. The disease is caused by the formation of large deposits of cholesterol in the walls of major blood vessels. This cholesterol comes from cholesterol-carrying particles in the blood which penetrate into the tissue of the blood vessel. They are taken up by the cells of the tissue which become engorged with large amounts of cholesterol and are called 'foam cells'. These foam cells also contain a small but signficant amount of damaged (oxidised) forms of cholesterol, called oxysterols. We have found than an oxysterol called 7-ketocholesterol makes it difficult for cells to get rid of excess cholesterol. Therefore this oxysterol may be part of the reason why foam cells develop. This project will study how 7-ketocholesterol blocks cholesterol removal from cells. This may lead to the development of drugs which remove or prevent 7-ketcholesterol accumulation in the blood vessel and so prevent or reverse atherosclerosis.Read moreRead less
Ras Signalling And Cholesterol Efflux From Late Endosomes
Funder
National Health and Medical Research Council
Funding Amount
$276,598.00
Summary
Accumulation of cholesterol is a hallmark of early atherosclerotic lesions, known as foam cell formation. Hence the stimulation of cholesterol removal (efflux) from macrophages has great therapeutic potential. High Density Lipoproteins (HDL) and apolipoprotein A-I (apoA-I) stimulate efflux via activation of HDL-apoA-I receptors and poorly understood signalling pathways. This application is investigating the role of the Ras-MAPK signalling pathway in promoting efflux from late endosomes.