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Page 10 of 14 Orekhov et al. Vessel Plus 2019;3:3 I http://dx.doi.org/10.20517/2574-1209.2018.80

40

Atherosclerotic risk reduction, % 20

30

10

0
10 20 30 40
LDL reduction, % of baseline

Figure 2. Consensus relationship between treatment effect on the low-density lipoprotein (LDL) level and the reduction in the risk of
atherosclerosis-related cardiovascular events. Adopted from [73] , with permission

[67]
cholesterol and cholesteryl esters . It should be noted that the content and composition of lipids in cultured
cells within the first 10-12 days in culture remain unchanged and correspond to the respective indices of
freshly isolated cells [67,68] .

In the ex vivo model, instead of drugs, blood sera taken from patients after oral drug administration is added
to cultured cells. Cell cultures can be employed in an ex vivo model to examine an indirect anti-atherogenic
action of a drug and to optimize anti-atherosclerotic (anti-atherogenic) drug therapies. The cellular models
can be used not only to test drugs but can also be used to test foodstuffs as well. Anti-atherosclerotic
(therapeutic, causing regression of atherosclerosis) and anti-atherogenic (preventive) activities of many agents
were investigated. This approach will be useful in the development and optimization of anti-aterhosclerotic
and anti-atherogenic dietary therapies. The anti-atherogenic effects of dietary products promote the
development of anti-atherosclerotic therapies based on natural products. Atherosclerosis develops over
many years, so anti-atherosclerotic therapies should be long-term or even lifelong. For such long-term
therapies, conventional medicine will not work. Drugs based on natural products can be a good alternative.
Among the anti-atherogenic natural products, the most effective was garlic. Two-year treatment with Allicor
[69]
(garlic powder) has a direct anti-atherosclerotic effect on carotid atherosclerosis in asymptomatic men .
Inflaminat (calendula, elder and violet), which possesses anti-cytokine activity, caused the regression of
[70]
carotid atherosclerosis in a 1-year treatment of asymptomatic men . The phytoestrogen-rich drug Karinat
(garlic powder, extract of grape seeds, green tea leaves, hop cones, β-carotene, α-tocopherol and ascorbic
[71]
acid) prevented the development of carotid atherosclerosis in postmenopausal women .

Although some herbal preparations are recommended by the FDA; unfortunately, natural products that
possess anti-atherosclerotic therapeutic potential are not prescribed by medical practitioners as anti-
atherosclerotic agents. However, the potential of these substances allows us to consider them as mainline
[72]
additional supplements or prescriptions .

CONCLUSION
The accumulation of intracellular lipids leading to foam cell formation is induced by modified LDL. This is a
fundamental event in the genesis of atherosclerotic lesions. It is the accumulation of intracellular lipids that