Some pitfalls in testing antiatherogenic agents in cell cultures

There is a tendency that some placebos and potentially harmful agents are presented as evidence-based medications; while theoretical concepts are sometimes created or existing ones misused for this purpose. In a large series of studies, having become known internationally after a publication in The Lancet (1986;2:595) and continued until the present day, it was reported that culturing of smooth muscle cells or macrophages with the serum from atherosclerosis patients caused intracellular cholesterol accumulation, whereas serum from healthy controls had no such effect. The cell cultures were used for evaluation of antiatherogenic drugs and dietary supplements including natural products; and corresponding scientific articles were used for their official registration. It is however known that antiatherogenic agents can influence lipid metabolism, cholesterol synthesis, or endotheliumrelated mechanisms. All these targets are absent in the cell monocultures. In vivo, relationship between cholesterol uptake by cells and atherogenesis is inverse rather than direct; for example, in familial hypercholesterolemia and other conditions discussed here, decreased clearance of LDL-cholesterol by cellular uptake causes hypercholesterolemia and predisposes to atherosclerosis. In conclusion, inadequate testing systems are sometimes used for registration of drugs and dietary supplements. As a result, supposedly antiatherogenic medications with unproven effects are then offered to the elderly patients misinformed not only by advertising but also by certain scientific papers. © 2014 Nova Science Publishers, Inc.