Raras
Buscar doenças, sintomas, genes...
Hipercolesterolemia familiar homozigótica
ORPHA:391665CID-10 · E78.0CID-11 · 5C80.00DOENÇA RARA

A proteína microssomal de transferência de triglicéridos, frequentemente abreviada como MTTP, funciona como uma espécie de «carregadora» ou «montadora» essencial dentro das células humanas, especificamente no fígado e no intestino delgado. Para o corpo transportar gorduras (lípidos) através do sangue, como a gordura e a água não se misturam, as gorduras precisam de ser embaladas em «veículos» especiais chamados lipoproteínas. A MTTP é a operária responsável por inserir componentes como triglicéridos e fosfolípidos numa proteína estrutural chamada apolipoproteína B. Sem a intervenção direta da MTTP, estas partículas de transporte simplesmente não poderiam ser formadas corretamente, e a gordura ficaria «presa» dentro das células em vez de circular para fornecer energia ao resto do organismo.

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Introdução

O que você precisa saber de cara

📋

Doença rara do metabolismo lipídico caracterizada por níveis plasmáticos de colesterol total e de colesterol de lipoproteína de baixa densidade (LDL) muito elevados e subsequente formação prematura de placas ateroscleróticas nas artérias coronárias, aorta proximal e outras artérias, aumentando significativamente o risco de doença cardiovascular prematura e morte. Os xantomas na pele e nos tendões também são uma característica da doença. A letalidade é elevada devido a complicações precoces, em particular enfarte do miocárdio e doença valvular aórtica.

Pesquisas ativas
17 ensaios
81 total registrados no ClinicalTrials.gov
Publicações científicas
1.007 artigos
Último publicado: 2026 Mar
Medicamentos
13 registrados
EVINACUMAB, EVOLOCUMAB, ROSUVASTATIN

Tem tratamento?

13 medicamentos registrados
Ver detalhes, fases e interações →
EVINACUMABEVOLOCUMABROSUVASTATINALIROCUMABLOMITAPIDEINCLISIRANANACETRAPIBLOMITAPIDE MESYLATELERODALCIBEPEZETIMIBE

Escala de raridade

CLASSIFICAÇÃO ORPHANET · BRASIL 2024
1-9 / 1 000 000
Ultra-rara
<1/50k
Muito rara
1/20k
Rara
1/10k
Pouco freq.
1/5k
Incomum
1/2k
Prevalência
0.3194
Worldwide
Início
Neonatal
🏥
SUS: Cobertura mínimaScore: 15%
1 medicamentos CEAFCID-10: E78.0
🇧🇷Dados SUS / DATASUS
PROCEDIMENTOS SIGTAP (6)
0202010279
Dosagem de aminoácidos (erros inatos)metabolic_test
0202010295
Dosagem de ácidos orgânicos na urinagenetic_test
0202010490
Teste de triagem para erros inatos do metabolismonewborn_screening
0202010694
Sequenciamento completo do exoma (WES)rehabilitation
0202080013
Teste do pezinho (triagem neonatal)
0301070040
Atendimento em reabilitação — doenças raras
Você se identifica com essa condição?
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Entender a doença

Do básico ao detalhe, leia no seu ritmo

Preparando trilha educativa...

Sinais e sintomas

O que aparece no corpo e com que frequência cada sintoma acontece

Partes do corpo afetadas

❤️
Coração
9 sintomas
🫘
Rins
2 sintomas
🧠
Neurológico
2 sintomas
😀
Face
1 sintomas
🫃
Digestivo
1 sintomas
👁️
Olhos
1 sintomas

+ 16 sintomas em outras categorias

Características mais comuns

100%prev.
Hiperlipidemia
100%prev.
Aumento da concentração de colesterol LDL
100%prev.
Hipercolesterolemia
90%prev.
Arteriosclerose prematura
Muito frequente (99-80%)
90%prev.
Aterosclerose precoce
Muito frequente (99-80%)
55%prev.
Angina pectoris
Frequente (79-30%)
33sintomas
Muito frequente (5)
Frequente (17)
Ocasional (7)
Muito raro (4)

Os sintomas variam de pessoa para pessoa. Abaixo estão as 33 características clínicas mais associadas, ordenadas por frequência.

HiperlipidemiaHyperlipidemia
Muito frequente100%
Aumento da concentração de colesterol LDLIncreased LDL cholesterol concentration
Muito frequente100%
HipercolesterolemiaHypercholesterolemia
Muito frequente100%
Arteriosclerose prematuraPremature arteriosclerosis
Muito frequente (99-80%)90%
Aterosclerose precocePrecocious atherosclerosis
Muito frequente (99-80%)90%

Linha do tempo da pesquisa

Publicações por ano — veja quando o interesse científico cresceu
Anos de pesquisa1desde 2026
Total histórico1.007PubMed
Últimos 10 anos200publicações
Pico202576 papers
Linha do tempo
2026Hoje · 2026🧪 1992Primeiro ensaio clínico📈 2025Ano de pico
Publicações por ano (últimos 10 anos)

Encontrou um erro ou informação desatualizada? Sugira uma correção →

Genética e causas

O que está alterado no DNA e como passa nas famílias

Genes associados

6 genes identificados com associação a esta condição. Padrão de herança: Autosomal dominant, Autosomal recessive.

PCSK9Proprotein convertase subtilisin/kexin type 9Disease-causing germline mutation(s) inTolerante
FUNÇÃO

Crucial player in the regulation of plasma cholesterol homeostasis. Binds to low-density lipid receptor family members: low density lipoprotein receptor (LDLR), very low density lipoprotein receptor (VLDLR), apolipoprotein E receptor (LRP1/APOER) and apolipoprotein receptor 2 (LRP8/APOER2), and promotes their degradation in intracellular acidic compartments (PubMed:18039658). Acts via a non-proteolytic mechanism to enhance the degradation of the hepatic LDLR through a clathrin LDLRAP1/ARH-mediat

LOCALIZAÇÃO

CytoplasmSecretedEndosomeLysosomeCell surfaceEndoplasmic reticulumGolgi apparatus

VIAS BIOLÓGICAS (2)
Post-translational protein phosphorylationRegulation of Insulin-like Growth Factor (IGF) transport and uptake by Insulin-like Growth Factor Binding Proteins (IGFBPs)
MECANISMO DE DOENÇA

Hypercholesterolemia, familial, 3

A form of hypercholesterolemia, a disorder of lipoprotein metabolism characterized by elevated serum low-density lipoprotein (LDL) cholesterol levels, which result in excess deposition of cholesterol in tissues and leads to xanthelasma, xanthomas, accelerated atherosclerosis and increased risk of premature coronary heart disease. FHCL3 inheritance is autosomal dominant.

EXPRESSÃO TECIDUAL(Tecido-específico)
Fígado
25.6 TPM
Cérebro - Hemisfério cerebelar
23.5 TPM
Cerebelo
22.1 TPM
Pulmão
6.7 TPM
Esôfago - Mucosa
4.9 TPM
OUTRAS DOENÇAS (2)
hypercholesterolemia, autosomal dominant, 3homozygous familial hypercholesterolemia
HGNC:20001UniProt:Q8NBP7
LDLRLow-density lipoprotein receptorDisease-causing germline mutation(s) inTolerante
FUNÇÃO

Binds low density lipoprotein /LDL, the major cholesterol-carrying lipoprotein of plasma, and transports it into cells by endocytosis. In order to be internalized, the receptor-ligand complexes must first cluster into clathrin-coated pits. Forms a ternary complex with PGRMC1 and TMEM97 receptors which increases LDLR-mediated LDL internalization (PubMed:30443021) (Microbial infection) Acts as a receptor for hepatitis C virus in hepatocytes, but not through a direct interaction with viral proteins

LOCALIZAÇÃO

Cell membraneMembrane, clathrin-coated pitGolgi apparatusEarly endosomeLate endosomeLysosome

VIAS BIOLÓGICAS (5)
Chylomicron clearanceLDL clearanceClathrin-mediated endocytosisCargo recognition for clathrin-mediated endocytosisRetinoid metabolism and transport
MECANISMO DE DOENÇA

Hypercholesterolemia, familial, 1

A form of hypercholesterolemia, a disorder of lipoprotein metabolism characterized by elevated serum low-density lipoprotein (LDL) cholesterol levels, which result in excess deposition of cholesterol in tissues and leads to xanthelasma, xanthomas, accelerated atherosclerosis and increased risk of premature coronary heart disease. FHCL1 inheritance is autosomal dominant.

EXPRESSÃO TECIDUAL(Ubíquo)
Glândula adrenal
91.8 TPM
Pulmão
78.6 TPM
Ovário
61.5 TPM
Fibroblastos
59.4 TPM
Esôfago - Mucosa
58.4 TPM
OUTRAS DOENÇAS (2)
hypercholesterolemia, familial, 1homozygous familial hypercholesterolemia
HGNC:6547UniProt:P01130
ABCG8ATP-binding cassette sub-family G member 8Candidate gene tested inTolerante
FUNÇÃO

ABCG5 and ABCG8 form an obligate heterodimer that mediates Mg(2+)- and ATP-dependent sterol transport across the cell membrane. Plays an essential role in the selective transport of the dietary cholesterol in and out of the enterocytes and in the selective sterol excretion by the liver into bile (PubMed:11099417, PubMed:11452359, PubMed:15054092, PubMed:27144356). Required for normal sterol homeostasis (PubMed:11099417, PubMed:11452359, PubMed:15054092). The heterodimer with ABCG5 has ATPase act

LOCALIZAÇÃO

Cell membraneApical cell membrane

VIAS BIOLÓGICAS (3)
ABC transporters in lipid homeostasisDefective ABCG5 causes sitosterolemiaNR1H3 & NR1H2 regulate gene expression linked to cholesterol transport and efflux
MECANISMO DE DOENÇA

Gallbladder disease 4

One of the major digestive diseases. Gallstones composed of cholesterol (cholelithiasis) are the common manifestations in western countries. Most people with gallstones, however, remain asymptomatic through their lifetimes.

OUTRAS DOENÇAS (4)
sitosterolemia 1homozygous familial hypercholesterolemiasitosterolemiagallbladder disease 4
HGNC:13887UniProt:Q9H221
ABCG5ATP-binding cassette sub-family G member 5Candidate gene tested inTolerante
FUNÇÃO

ABCG5 and ABCG8 form an obligate heterodimer that mediates Mg(2+)- and ATP-dependent sterol transport across the cell membrane (PubMed:27144356). Plays an essential role in the selective transport of dietary plant sterols and cholesterol in and out of the enterocytes and in the selective sterol excretion by the liver into bile (PubMed:11099417, PubMed:11138003, PubMed:15054092, PubMed:27144356). Required for normal sterol homeostasis (PubMed:11099417, PubMed:11138003, PubMed:15054092). The heter

LOCALIZAÇÃO

Cell membraneApical cell membrane

VIAS BIOLÓGICAS (3)
ABC transporters in lipid homeostasisDefective ABCG8 causes GBD4 and sitosterolemiaNR1H3 & NR1H2 regulate gene expression linked to cholesterol transport and efflux
MECANISMO DE DOENÇA

Sitosterolemia 2

A form of sitosterolemia, an autosomal recessive metabolic disorder characterized by unregulated intestinal absorption of cholesterol, phytosterols and shellfish sterols, and decreased biliary excretion of dietary sterols into bile. Patients have hypercholesterolemia, very high levels of plant sterols in the plasma, and frequently develop tendon and tuberous xanthomas, accelerated atherosclerosis and premature coronary artery disease.

OUTRAS DOENÇAS (3)
sitosterolemia 2sitosterolemiahomozygous familial hypercholesterolemia
HGNC:13886UniProt:Q9H222
APOBApolipoprotein B-100Disease-causing germline mutation(s) inRestrito
FUNÇÃO

Apolipoprotein B is a major protein constituent of chylomicrons (apo B-48), LDL (apo B-100) and VLDL (apo B-100). Apo B-100 functions as a recognition signal for the cellular binding and internalization of LDL particles by the apoB/E receptor

LOCALIZAÇÃO

CytoplasmSecretedLipid droplet

VIAS BIOLÓGICAS (8)
Platelet sensitization by LDLHeme signalingScavenging by Class B ReceptorsCell surface interactions at the vascular wallLDL remodeling
MECANISMO DE DOENÇA

Hypobetalipoproteinemia, familial, 1

A disorder of lipid metabolism characterized by less than 5th percentile age- and sex-specific levels of low density lipoproteins, and dietary fat malabsorption. Clinical presentation may vary from no symptoms to severe gastrointestinal and neurological dysfunction similar to abetalipoproteinemia.

OUTRAS DOENÇAS (3)
hypercholesterolemia, autosomal dominant, type Bfamilial hypobetalipoproteinemia 1homozygous familial hypercholesterolemia
HGNC:603UniProt:P04114
LDLRAP1Low density lipoprotein receptor adapter protein 1Disease-causing germline mutation(s) inTolerante
FUNÇÃO

Adapter protein (clathrin-associated sorting protein (CLASP)) required for efficient endocytosis of the LDL receptor (LDLR) in polarized cells such as hepatocytes and lymphocytes, but not in non-polarized cells (fibroblasts). May be required for LDL binding and internalization but not for receptor clustering in coated pits. May facilitate the endocytosis of LDLR and LDLR-LDL complexes from coated pits by stabilizing the interaction between the receptor and the structural components of the pits.

LOCALIZAÇÃO

Cytoplasm

VIAS BIOLÓGICAS (6)
Transport of RCbl within the bodyVitamin D (calciferol) metabolismChylomicron clearanceLDL clearanceClathrin-mediated endocytosis
MECANISMO DE DOENÇA

Hypercholesterolemia, familial, 4

A form of hypercholesterolemia, a disorder of lipoprotein metabolism characterized by elevated serum low-density lipoprotein (LDL) cholesterol levels, which result in excess deposition of cholesterol in tissues and leads to xanthelasma, xanthomas, accelerated atherosclerosis and increased risk of premature coronary heart disease. FHCL4 inheritance is autosomal recessive.

EXPRESSÃO TECIDUAL(Ubíquo)
Cerebelo
129.4 TPM
Cérebro - Hemisfério cerebelar
115.4 TPM
Baço
69.7 TPM
Brain Spinal cord cervical c-1
49.2 TPM
Aorta
34.6 TPM
OUTRAS DOENÇAS (2)
hypercholesterolemia, familial, 4homozygous familial hypercholesterolemia
HGNC:18640UniProt:Q5SW96

Medicamentos e terapias

EVINACUMABPhase 4

Mecanismo: Angiopoietin-related protein 3 inhibitor

EVOLOCUMABPhase 4

Mecanismo: Subtilisin/kexin type 9 inhibitor

ROSUVASTATINPhase 3

Mecanismo: HMG-CoA reductase inhibitor

ALIROCUMABPhase 3

Mecanismo: Subtilisin/kexin type 9 inhibitor

LOMITAPIDEPhase 3

Mecanismo: Microsomal triglyceride transfer protein inhibitor

INCLISIRANPhase 3

Mecanismo: PCSK9 mRNA RNAi inhibitor

ANACETRAPIBPhase 3

Mecanismo: Cholesteryl ester transfer protein inhibitor

LOMITAPIDE MESYLATEPhase 3

Mecanismo: Microsomal triglyceride transfer protein inhibitor

LERODALCIBEPPhase 3

Mecanismo: Subtilisin/kexin type 9 inhibitor

EZETIMIBEPhase 2

Mecanismo: Niemann-Pick C1-like protein 1 inhibitor

Ver mais no OpenTargets

Variantes genéticas (ClinVar)

4,374 variantes patogênicas registradas no ClinVar.

🧬 LDLRAP1: NM_015627.3(LDLRAP1):c.17_20del (p.Ser6fs) ()
🧬 LDLRAP1: NM_015627.3(LDLRAP1):c.89-5C>G ()
🧬 LDLRAP1: NM_015627.3(LDLRAP1):c.450G>A (p.Lys150=) ()
🧬 LDLRAP1: NM_015627.3(LDLRAP1):c.783-11C>T ()
🧬 LDLRAP1: NM_015627.3(LDLRAP1):c.559C>T (p.Gln187Ter) ()
Ver todas no ClinVar

Classificação de variantes (ClinVar)

Distribuição de 132 variantes classificadas pelo ClinVar.

132
Patogênica (100.0%)
VARIANTES MAIS SIGNIFICATIVAS
LDLR: NM_000527.5(LDLR):c.1988_2140+1064del [Likely pathogenic]
LDLR: NC_000019.10:g.(?_11110652)_(11110771_?)dup [Likely pathogenic]
LDLR: NC_000019.10:g.(?_11111514)_(11111639_?)del [Likely pathogenic]
LDLR: NC_000019.10:g.(?_11128008)_(11128085_?)del [Likely pathogenic]
LDLR: NC_000019.10:g.(?_11110652)_(11111639_?)del [Pathogenic]

Diagnóstico

Os sinais que médicos procuram e os exames que confirmam

Carregando...

Tratamento e manejo

Remédios, cuidados de apoio e o que precisa acompanhar

Pipeline de tratamentos
Pipeline regulatório — de medicamentos já aprovados a drogas em pesquisa exploratória.
Aprovado2
3Fase 314
2Fase 24
1Fase 12
·Pré-clínico8
Medicamentos catalogadosEnsaios clínicos· 10 medicamentos · 20 ensaios
✓ Aprovados — podem ser usados hoje
EVINACUMABEVOLOCUMAB
Carregando informações de tratamento...

Onde tratar no SUS

Hospitais de referência no Brasil e o protocolo oficial do SUS (PCDT)

🇧🇷 Atendimento SUS — Hipercolesterolemia familiar homozigótica

🗺️

Selecione um estado ou use sua localização para ver resultados.

Dados de DATASUS/CNES, SBGM, ABNeuro e Ministério da Saúde. Sempre confirme a disponibilidade diretamente com o estabelecimento.

Pesquisa ativa

Ensaios clínicos abertos e novidades científicas recentes

🟢 Recrutando agora

10 pesquisas recrutando participantes. Converse com seu médico sobre a possibilidade de participar.

Outros ensaios clínicos

81 ensaios clínicos encontrados, 17 ativos.

Distribuição por fase
Ver todos no ClinicalTrials.gov
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Publicações mais relevantes

Timeline de publicações
524 papers (10 anos)
#1

PCSK9-mediated degradation of cell-surface LDL receptors impairs human CD8+ T cell effector functions.

iScience2026 Mar 20

Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates circulating cholesterol levels by binding hepatic low-density lipoprotein (LDL) receptors (LDLRs) and directing them to lysosomal degradation. Beyond the liver, PCSK9 expression in multiple cancers, including colorectal, hepatocellular, and head and neck carcinomas, correlates with poor survival. We hypothesized that PCSK9 promotes LDLR degradation on CD8+ T cells, limiting cholesterol uptake and impairing antitumor immunity. Treatment of activated human CD8+ T cells from healthy donors with recombinant PCSK9 reduced surface LDLR and ICAM-1 expression, granzyme B secretion, and proliferation. The effects of PCSK9 treatment were reversed by PCSK9 inhibition or by culturing cells under lipoprotein-deprived conditions, confirming LDLR dependence. CD8+ T cells from patients with homozygous familial hypercholesterolemia, who harbor inactivating LDLR mutations, exhibited reduced proliferation and ICAM-1 expression upon activation. Together, these findings identify PCSK9 as a potential therapeutic target to enhance CD8+ T cell-mediated antitumor immunity.

#2

Anti-ANGPTL3 Antibody SHR-1918 for Homozygous Familial Hypercholesterolemia: A Nonrandomized Clinical Trial.

JAMA cardiology2026 Feb 01

Homozygous familial hypercholesterolemia (HoFH) is a rare, life-threatening genetic disorder. Patients with HoFH have markedly elevated low-density lipoprotein cholesterol (LDL-C) levels from birth, and their activity of LDL receptor (LDLR) is typically absent or severely impaired. However, efficacy of traditional lipid-regulating agents relies on residual LDLR function. Angiopoietinlike 3 (ANGPTL3)-directed therapies could reduce lipid levels through an LDLR-independent pathway. To evaluate SHR-1918, a fully human monoclonal antibody targeting ANGPTL3, in adults with HoFH taking stable lipid-lowering therapy. This was a multicenter, single-arm, phase 2 nonrandomized clinical trial conducted at 8 sites in China between December 19, 2023, and April 2, 2024. Included were participants with HoFH taking stable lipid-lowering therapy. Patients were given subcutaneous SHR-1918 at 600 mg every 4 weeks for 12 weeks, followed by an 8-week follow-up. The primary end point was the percent change in serum LDL-C level from baseline to week 12. A total of 26 patients (mean [SD] age, 36.1 [12.2] years; 16 female [61.5%]) were included in this analysis. The mean (SD) baseline LDL-C level was 433.59 (173.74) mg/dL. At week 12, the mean percent change in LDL-C level was -59.09% (SD, 11.71%; 95% CI, -63.81% to -54.36%). The reduction was observed throughout the entire 8-week follow-up period. SHR-1918 suggested similar LDL-C reduction across HoFH genotypes, with a percent change from baseline to week 12 of -61.32% for homozygous, -56.40% for compound heterozygous, and -72.21% for double heterozygous. Overall, 16 patients (61.5%) had at least 1 treatment-emergent adverse event, with the most common being proteinuria (4 [15.4%]). Injection site reaction occurred in only 1 patient (3.8%) and included pain and rash or erythema (both grade 1). Results show that SHR-1918 was associated with a substantial reduction in LDL-C level and favorable safety profile among patients with HoFH taking stable lipid-lowering therapy. ClinicalTrials.gov Identifier: NCT06009393.

#3

[The safety and efficacy of adeno-associated virus-mediated LDLR transfection in homozygous familial hypercholesterolemia].

Zhonghua xin xue guan bing za zhi2026 Mar 24

Objective: To evaluate the safety and efficacy of an adeno-associated virus vector carrying an optimized human low density lipoprotein receptor (LDLR) gene (NGGT006) in the treatment of homozygous familial hypercholesterolemia (HoFH) with LDLR mutations. Methods: This is an open-label, single-center, single-arm, non-randomized, investigator-initiated clinical trial. According to the dose-escalation principle, enrolled HoFH patients received a single injection of NGGT006 at three different doses: low dose (7.5×1012 vg/kg), medium dose (1.5×1013 vg/kg), or high dose (3.0×1013 vg/kg). The primary endpoint of this study was the safety of NGGT006 treatment, evaluated by the incidence of drug-related adverse events and serious adverse events, and the efficacy of NGGT006 treatment, assessed by percentage and absolute changes in low density lipoprotein-cholesterol (LDL-C) levels. The early results of the first 3 patients after NGGT006 therapy in a 64-week follow-up were reported. Results: The 3 patients were aged 29 to 33 years, including 2 males, and the baseline serum LDL-C levels ranged from 8.95 to 11.17 mmol/L. No effective reduction in LDL-C levels was observed in patients 1 and 2, who were treated with low dose and medium dose of NGGT006, respectively. Patient 3 treated with a high dose of NGGT006 showed a rapid and persistent decrease in LDL-C levels. At the 64-week follow-up, the LDL-C level reduced from 11.17 mmol/L to 0.28 mmol/L, with a relative change of 97.49% compared with baseline. During the entire follow-up period, there were no serious adverse events in any of the patients. Only adverse events graded 2 or lower occurred, such as liver enzyme elevation and mild fever. Conclusions: NGGT006 gene therapy is generally safe and well-tolerated in HoFH patients with LDLR mutations. High-dose NGGT006 treatment can significantly reduce LDL-C levels. Further research is needed to evaluate its long-term efficacy. 目的: 评价一种携带经优化的人低密度脂蛋白受体(LDLR)基因的腺相关病毒载体NGGT006用于治疗LDLR突变的纯合子家族性高胆固醇血症的安全性和有效性。 方法: 本研究为研究者发起的临床研究,是一项开放、单中心、单臂、非随机的前瞻性临床试验。符合纳入标准的纯合子家族性高胆固醇血症患者,采用剂量递增方案,分别接受低剂量7.5×1012 vg/kg,中剂量1.5×1013 vg/kg,高剂量3.0×1013 vg/kg的NGGT006单次注射。对患者进行随访,主要研究终点为NGGT006治疗的安全性,即不良事件和严重不良事件的发生情况,以及NGGT006治疗的有效性,即低密度脂蛋白胆固醇(LDL-C)水平的百分比及绝对值变化。本次对首批分别接受低、中、高剂量治疗的3例患者随访64周的结果进行汇报。 结果: 3例患者年龄为29~33岁,男性2例,基线血清LDL-C水平为8.95~11.17 mmol/L。低、中剂量治疗的2例患者未观察到有效的LDL-C降低。高剂量治疗的患者出现快速、持久的LDL-C下降,随访64周时其LDL-C水平从11.17 mmol/L降至0.28 mmol/L,较基线下降97.49%。整个随访期间所有患者均未发生严重不良事件,治疗期间仅出现肝酶升高和轻度发热等2级及以下的不良事件。 结论: NGGT006治疗LDLR基因突变的纯合子家族性高胆固醇血症具有良好的安全性和耐受性,高剂量NGGT006治疗可明显降低LDL-C水平,其长期疗效仍需进一步验证。.

#4

Lomitapide reduces viability and clonogenicity in hepatocellular carcinoma cells but enhances xenograft growth: The importance of the tumor microenvironment.

The Journal of pharmacology and experimental therapeutics2026 Feb 12

Lomitapide, a microsomal triglyceride transfer protein inhibitor approved for the treatment of homozygous familial hypercholesterolemia, has recently attracted interest as a potential anticancer agent because of its effects on lipid metabolism. Given the central role of lipid handling in hepatocellular carcinoma (HCC), we investigated the impact of lomitapide-mediated microsomal triglyceride transfer protein inhibition using complementary in vitro and in vivo models. Lomitapide induced intracellular lipid accumulation and reduced cell viability and clonogenicity in human HCC cell lines (Huh7 and HepG2) in a dose-dependent manner, without affecting cell migration. However, in a subcutaneous xenograft model, lomitapide treatment paradoxically promoted tumor growth, increasing tumor volume, weight, and proliferative markers, whereas apoptosis-related proteins remained unchanged. Tumors from lomitapide-treated mice exhibited enhanced extracellular signal-regulated kinase (ERK) signaling and increased lipid accumulation, alongside reduced systemic lipoprotein levels. To reconcile these opposing effects, we examined the contribution of the tumor microenvironment. Coculture experiments revealed reduced sensitivity of HCC cells to lomitapide in the presence of nonparenchymal cells. Conditioned media studies identified hepatic stellate cells as key mediators of this resistance, associated with increased secretion of interleukin 8 and vascular endothelial growth factor after lomitapide exposure. These factors are known activators of proliferative signaling pathways in HCC. Collectively, our findings demonstrate that lomitapide exerts direct antiproliferative effects on HCC cells under simplified conditions, but promotes tumor growth in vivo through microenvironment-dependent mechanisms. This study highlights the critical influence of stromal-tumor interactions on therapeutic outcomes and urges caution in repurposing lipid-modulating drugs for cancer treatment without accounting for tissue context. SIGNIFICANCE STATEMENT: This study demonstrates that inhibition of microsomal triglyceride transfer protein exerts opposite effects on hepatocellular carcinoma depending on biological context, suppressing tumor cell growth in vitro while promoting tumor expansion in vivo. These findings reveal a decisive role for the tumor microenvironment, particularly stromal cell-derived protumorigenic signals, in shaping therapeutic responses to lipid-modulating drugs.

#5

LDL-C target achievement after adding evinacumab in 2 patients with autosomal recessive hypercholesterolemia.

Journal of clinical lipidology2026 Feb 13

Autosomal recessive hypercholesterolemia (ARH) is a rare form of genetic hypercholesterolemia consequent to pathogenic variants in the low-density lipoprotein receptor adaptor protein 1 (LDLRAP1) gene, coding for a protein responsible for moving LDL-receptor (LDL-R) to its site of activity. ARH is characterized by very high levels of LDL cholesterol (LDL-C), leading to aggressive and frequently premature atherosclerotic cardiovascular disease (ASCVD). Lowering of LDL-C is the main target of treatment; however, classical lipid-lowering agents, for example, statins, frequently have a modest response, in view of their selective LDL-R-raising activity. Among newer agents with an LDL-R-independent mechanism, evinacumab has been shown to be effective in homozygous familial hypercholesterolemia, but few data are available in LDLRAP1 variant carriers. We here report 2 cases of this extremely rare form of familial hypercholesterolemia with a surprising response to evinacumab. Evinacumab was added to maximally tolerated background therapy. In the first patient, who had severe ASCVD and a prior inadequate response to statins, proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitors, and lomitapide, evinacumab reduced time-averaged LDL-C by 82% (from 549 to 62 mg/dL). In the second patient, evinacumab achieved a sustained 73.8% LDL-C reduction, maintaining levels <55 mg/dL and allowing discontinuation of the PCSK9 inhibitor. These cases demonstrate a marked and clinically meaningful LDL-C-lowering effect of evinacumab in ARH, supporting its use as an effective LDL-R-independent therapeutic option.

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Liver transplantation for homozygous familial hypercholesterolemia: Cure for a genetic disease?

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Long-term outcomes of liver transplantation for homozygous familial hypercholesterolaemia in Australia and New Zealand.

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Circulation
2023

New opportunities in the management and treatment of refractory hypercholesterolemia using in vivo CRISPR-mediated genome/base editing.

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2023

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2023

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2023

Modelling the potential long-term survival benefit of evinacumab treatment vs. standard of care in patients with homozygous familial hypercholesterolaemia.

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2023

Treatment of Homozygous Familial Hypercholesterolemia With ANGPTL3 Inhibitor, Evinacumab.

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2023

Multiple Xanthoma Tuberosum in a Case of Familial Homozygous Hypercholesterolemia.

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2023

Homozygous Familial Hypercholesterolemia: The Future Looks Brighter But Not for All.

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2023

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2023

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2023

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Arteriosclerosis, thrombosis, and vascular biology
2023

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Journal of the American Heart Association
2023

Homozygous Familial Hypercholesterolemia in Canada: An Observational Study.

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2023

A human iPSC-derived hepatocyte screen identifies compounds that inhibit production of Apolipoprotein B.

Communications biology
2023

Lipoprotein(a) levels in children with homozygous familial hypercholesterolaemia: A cross-sectional study.

Journal of clinical lipidology
2024

Evinacumab-dgnb (Evkeeza-REGN1500), A Novel Lipid-Lowering Therapy for Homozygous Familial Hypercholesterolemia.

Cardiology in review
2023

Gene Therapy for Paediatric Homozygous Familial Hypercholesterolaemia.

Heart, lung &amp; circulation
2023

[State of the art: lipoprotein apheresis].

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2023

How Genetic Variants in Children with Familial Hypercholesterolemia Not Only Guide Detection, but Also Treatment.

Genes
2023

Concurrent Living Donor Liver Transplantation and Off-Pump Coronary Artery Bypass in a Five-Year-Old Child With Homozygous Familial Hypercholesterolemia: A Case Report.

Transplantation proceedings
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Individualized dosing of evinacumab is predicted to yield reductions in drug expenses.

Journal of clinical lipidology
2023

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Nutrients
2023

SARS-CoV-2 infection-related deregulation of blood lipids in a patient with -/-LDLR familial homozygous hypercholesterolemia: A case report.

Journal of clinical lipidology
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Current opinion in lipidology
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Frontiers in genetics
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Pharmaceuticals (Basel, Switzerland)
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Metabolomic Approach to Screening Homozygotes in Chinese Patients with Severe Familial Hypercholesterolemia.

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A PCSK9 inhibitor induces a transient decrease in the neutrophil-lymphocyte ratio and monocyte-lymphocyte ratio in homozygous familial hypercholesterolemia patients.

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Counseling couples at risk of having a child with homozygous familial hypercholesterolemia - Clinical experience and recommendations.

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2022

Homozygous Familial Hypercholesterolemia: Luck Meets Opportunity Meets Knowledge.

JACC. Case reports
Ver todos os 558 no EuropePMC

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Doenças relacionadas

Doenças com sintomas parecidos — ajudam quem ainda está buscando diagnóstico

Referências e fontes

Bases de dados externas citadas neste artigo

Publicações científicas

Artigos indexados no PubMed ligados a esta doença no grafo RarasNet — título, periódico e PMID direto da fonte, sem intermediação de IA.

  1. PCSK9-mediated degradation of cell-surface LDL receptors impairs human CD8+ T cell effector functions.
    iScience· 2026· PMID 41767258mais citado
  2. Anti-ANGPTL3 Antibody SHR-1918 for Homozygous Familial Hypercholesterolemia: A Nonrandomized Clinical Trial.
    JAMA cardiology· 2026· PMID 41499141mais citado
  3. [The safety and efficacy of adeno-associated virus-mediated LDLR transfection in homozygous familial hypercholesterolemia].
    Zhonghua xin xue guan bing za zhi· 2026· PMID 41866206mais citado
  4. Lomitapide reduces viability and clonogenicity in hepatocellular carcinoma cells but enhances xenograft growth: The importance of the tumor microenvironment.
    The Journal of pharmacology and experimental therapeutics· 2026· PMID 41795398mais citado
  5. LDL-C target achievement after adding evinacumab in 2 patients with autosomal recessive hypercholesterolemia.
    Journal of clinical lipidology· 2026· PMID 41775618mais citado
  6. Novel Approaches to Lipid Management: Beyond Statins and PCSK9 Inhibitors.
    J Clin Med Res· 2026· PMID 41953595recente
  7. Left Main Angioplasty for Acute Coronary Syndrome in 7-Year-Old Girl With Familial Hypercholesterolemia.
    JACC Case Rep· 2025· PMID 41945534recente
  8. Comparison of Clinical Characterization and Therapeutic Strategies between Homozygous Familial Hypercholesterolemia and Heterozygous Familial Hypercholesterolemia.
    J Atheroscler Thromb· 2026· PMID 41905938recente
  9. An Improved Prognosis in Subjects With Homozygous Familial Hypercholesterolemia Associated With Advances in LDL-Lowering Therapy.
    J Atheroscler Thromb· 2026· PMID 41905937recente
  10. Traditional cardiovascular risk factors and their association with atherosclerotic cardiovascular disease in homozygous familial hypercholesterolemia: A cross-sectional analysis from the HICC registry.
    Atherosclerosis· 2026· PMID 41903299recente

Bases de dados e fontes oficiais

Identificadores e referências canônicas usadas para montar este verbete.

  1. ORPHA:391665(Orphanet)
  2. MONDO:0018328(MONDO)
  3. GARD:10416(GARD (NIH))
  4. Variantes catalogadas(ClinVar)
  5. Busca completa no PubMed(PubMed)
  6. Q15815863(Wikidata)

Dados compilados pelo RarasNet a partir de fontes abertas (Orphanet, OMIM, MONDO, PubMed/EuropePMC, ClinicalTrials.gov, DATASUS, PCDT/MS). Este conteúdo é informativo e não substitui avaliação médica.

Conteúdo mantido por Agente Raras · Médicos e pesquisadores podem colaborar

Hipercolesterolemia familiar homozigótica
Compêndio · Raras BR

Hipercolesterolemia familiar homozigótica

ORPHA:391665 · MONDO:0018328
🇧🇷 Brasil SUS
CEAF
1AEvinacumabe
Geral
Prevalência
1-9 / 1 000 000
Herança
Autosomal dominant, Autosomal recessive
CID-10
E78.0 · Hipercolesterolemia pura
CID-11
Ensaios
17 ativos
Medicamentos
13 registrados
Início
Neonatal
Prevalência
0.3194 (Worldwide)
MedGen
UMLS
C0342881
Repurposing
12 candidatos
bezafibratePPAR receptor agonist
clofibrateprostanoid receptor antagonist
laropiprantcholesterol inhibitor|Niemann-Pick C1-like 1 protein antagonist
+9 outros
EuropePMC
Wikidata
Papers 10a
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