Aberrations in lipid metabolism lead to a plethora of clinical symptomatologies often with dire consequences for humans. Therefore, regulating lipid metabolism constitutes a significant step toward prevention, alleviation of clinical symptoms and potential cure for some of the diseases arising from aberrant lipid metabolism.
Alufibrate® is a common drug employed in the regulation of lipid metabolism. Its action concentrates on the decrease of the concentrations of cholesterol and triglycerides in blood.55 As such, it is used for combating atherosclerosis and hypertension. To this end, characteristic diseases toward which Alufibrate® acts include hyperliproteinemias (e.g. type IIa, type IIb and type IV hyperlipidemias).56
The drug bears the formulation bis[2-(p-chlorophenoxy)-2-methylpropionato]-hydroxyaluminum, essentially the basic aluminum salt of clofibric acid (Figure 4.3).
The clinical efficacy of Alufibrate® in hyperlipidemic patients has been well established.57 The drug is known to lower serum levels of triglycerides more so than cholesterol. A number of clinical investigations have attempted to delineate the mechanism of action of the drug, yet its mode of action is not fully understood. According to those investigations, inhibition of acetyl-CoA carboxylase by hypolipidemic medication, like Alufibrate®, may be linked to less acetyl-CoA
Figure 4.3 Structure of clofibric acid being used for fatty acid synthesis, thus providing more of that substrate for oxidation.58 Alufibrate® was also observed to reduce the concentration of very low density lipoproteins (VLDL), which may be attributed to diminished synthesis of VLDL lipids.
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