title: Dipeptidyl peptidase-4 inhibitors and their potential role in the management of atherosclerosis--A review.
abstract: BACKGROUND
  Dipeptidyl peptidase-4 (DPP-4) inhibitors are a relatively new class of anti-diabetic drugs that have therapeutic potential in the management of atherosclerosis. Of the numerous DPP-4 inhibitors in clinical practice no studies have been conducted to compare their anti-atherosclerotic effects despite growing evidence of their usefulness in the high risk population.
  
  
  OBJECTIVE
  The aim of the study was to review the anti-athero-thrombotic effects of DPP-4 inhibitors in atherosclerotic diseases.
  
  
  METHODS
  A literature search was conducted on MEDLINE and the COCHRANE Library using the terms "DPP-4 Inhibitors", "atherosclerosis", "GLP", "inflammation", "cytokines", "stroke", "ischaemic heart disease", "hypertension" and "peripheral vascular disease". A mathematical model devised by us was used to derive and compare the anti-inflammatory effects of the DPP-4 inhibitors using protective score [PS]. Data was analysed for alogliptin, linagliptin, saxagliptin, sitagliptin, and vildagliptin.
  
  
  RESULTS
  Sixty two published studies collected in the search were assessed for relevance to this study. Sitagliptin had the highest PS [n=5] while linagliptin and saxagliptin yielded the lowest PS [n=1]. This comparison and scoring system was limited to the data collected; which did not investigate for all athero-thrombotic factors selected in this study.
  
  
  CONCLUSIONS
  The findings suggest potential usefulness of DPP-4 in atherosclerotic diseases. It also reflected a possible superiority of sitagliptin over the other DPP-4 inhibitors in the management of atherosclerosis. Further investigations are required to establish specific inflammatory cytokines influenced by the DPP-4 inhibitors and to elucidate their clinical application in athero-thrombotic disease.
authors.affiliation: Translational Research on Endocrinology and Diabetes [TREAD], School of Medicine and Dentistry, James Cook University Townsville, Australia.
authors.forename: Tejas P
authors.initials: TP
authors.lastname: Singh
authors.affiliation: Translational Research on Endocrinology and Diabetes [TREAD], School of Medicine and Dentistry, James Cook University Townsville, Australia.
authors.forename: Venkat N
authors.initials: VN
authors.lastname: Vangaveti
authors.affiliation: Translational Research on Endocrinology and Diabetes [TREAD], School of Medicine and Dentistry, James Cook University Townsville, Australia. Electronic address: usman.malabu@jcu.edu.au.
authors.forename: Usman H
authors.initials: UH
authors.lastname: Malabu
mesh_terms: D050197:Atherosclerosis / Q000517:prevention & control*; D054873:Dipeptidyl-Peptidase IV Inhibitors / Q000627:therapeutic use*; D019468:Disease Management; D006801:Humans; D011379:Prognosis
chemical_list: D054873:Dipeptidyl-Peptidase IV Inhibitors
keywords: Atherosclerosis; Cytokines; DPP-4 inhibitors; Diabetes