There are a few genes in which rare variants have been noted to dramatically lower blood cholesterol and other lipids, thus significantly reducing the progression of atherosclerosis with age. ANGPTL4 is one of them, and based on the work here, so is ANGPTL3. Atherosclerosis is caused by inappropriate reactions to forms of damaged lipids, leading to the formation of plaques that weaken and narrow blood vessels. Lowering overall lipid levels doesn’t address these consequences, but it does reduce the input of damaged lipids to the disease process, hence the major industry associated with statin drugs and other methods of reducing lipids in the bloodstream.
In the near future, it seems likely that statins will be replaced by more effective and narrowly targeted genetic means of reducing cholesterol. This has started with therapies in development based on manipulation of PCSK9, producing larger effects than statins. Of interest, studies in recent years have suggested that blood lipids can be reduced to an extremely low level, a tenth of normal amounts or less, with no harm resulting to patients. This may well be a useful general enhancement that everyone undergoes once permanent genetic
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