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Why Some Lipid Drugs Fail
A study published in *Nature* found that chronic exposure to a cholesterol-rich diet activates “Ral GTPase” proteins, which interact with the enzyme “CTSA.” This causes cholesterol receptors in liver cells to be broken down rather than recycled, weakening the liver’s ability to remove harmful cholesterol from the blood. This pathway operates independently of “PCSK9,” a protein targeted by some current treatments, and may help explain why some patients respond poorly to medication. In laboratory experiments, inhibiting “CTSA” helped protect the receptors and improve their stability. However, the findings are still at the research stage and do not mean that a new treatment is currently available.
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