title: Did we abandon probucol too soon?
abstract: OBJECTIVE
  Probucol is a potent antioxidative drug that has been used for prevention and treatment of atherosclerotic cardiovascular diseases and xanthoma. Probucol has been used as a lipid-lowering drug for a long time especially in Japan, although Western countries quitted its use because of the reduction in serum HDL-cholesterol (HDL-C). This review highlights both basic and clinical studies that provide new insights into the pleiotropic effects of probucol.
  
  
  RESULTS
  Recently, the mechanisms for the pharmacologic actions of probucol have been elucidated at the molecular level with a special focus on HDL metabolism and its functions. Probucol enhances plasma cholesteryl ester transfer protein activity and hepatic scavenger receptor class B type I, causing a decrease in HDL-C. It also accelerates the antioxidative function of HDL via increase in paraoxonase 1 activity. Recent retrospective analyses of probucol-treated patients with heterozygous familial hypercholesterolemia and those after coronary revascularization demonstrated a strong beneficial effect of probucol on secondary prevention of cardiovascular events and mortality.
  
  
  CONCLUSIONS
  Probucol has pleiotropic and beneficial therapeutic effects on cardiovascular system. Although statins are effective for lowering LDL-cholesterol (LDL-C) and reducing coronary heart disease risk, probucol should be considered as an option in case statins are not effective.
authors.affiliation: aDepartment of Community Medicine bDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine cSumitomo Hospital, Osaka, Japan.
authors.forename: Shizuya
authors.initials: S
authors.lastname: Yamashita
authors.forename: Daisaku
authors.initials: D
authors.lastname: Masuda
authors.forename: Yuji
authors.initials: Y
authors.lastname: Matsuzawa
mesh_terms: D000818:Animals; D001692:Biological Transport / Q000187:drug effects; D002319:Cardiovascular System / Q000187:drug effects; D002784:Cholesterol / Q000378:metabolism; D006801:Humans; D011341:Probucol / Q000737:chemistry / Q000494:pharmacology*
chemical_list: D002784:Cholesterol; D011341:Probucol