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The Proceedings of the Eight International Symposium on Drugs Affecting Lipid Metabolism (8th D.A.L.M.) is the subject of this volume. Since the first symposium in 1960, each successive meeting has broken new ground in the field of pharmacological control of lipid levels - offering new and stimulating insights and exposing the audience to the state of the art. The field has progressed sufficiently to permit discussion of the cellular biology of athero sclerosis. The opening session was devoted to pathology, macrophages, lipoproteins and their receptors and choles terol ester metabolism. Because of the recent emergence of new apolipoprotein technology, a workshop devoted sole ly to apolipoprotein methodology was introduced followed by a plenary session devoted to their metabolism and structure. Another rapidly developing area of atherosclerosis research is non-invasive assessment of this condition. Accordingly, a session was devoted to new techniques for this research modality. The final plenary sessions were devoted to the roles of drugs and diet in athero~ scl~rosis - cause, treatment and mechanisms of action. The meeting was summarized by Dr. O.J. Pollak, one of the "founding fathers" of this field. There were nine sessions of proffered papers whose abstracts appear in this volume. In addition, special workshops (to be reported elsewhere) were devoted to several drugs including Oiyzanol, Probucol and Etofibrate.
A great deal of experimental, clinical and epidemiological data have been gathered to confirm the strict and causal correlation between plasma lipoproteins and coronary heart disease. However, as usually happens in research, many more interesting issues are being studied, opening new fields of research for the future. These new advances, together with the combined efforts of cell biologists and lipoprotein chemists, have set the pace for an exciting period of research and clinical applications of diets and drugs affecting plasma and cell lipids. This volume, which includes the work of many of the leading world labortories, represents an authoritative and up-to-date appraisal of the status of the art and a stimulus to future research at the laboratory and clinical level in a fascinating area of clinical and preventive medicine.
This Symposium was the fourth in a series which began in Milan, Italy, in 1960. Each meeting has introduced or developed some new concepts in the areas of lipid metabolism and drugs. The meetings have served as a springboard for new ideas which have, between meetings, become accepted and exploited. This meeting has been no exception. Principal among the many new concepts discussed were lipoprotein synthesis and metabolism, apoprotein structure and function, whole body metabolism of cholesterol, and aspects of myocardial and aortic metabolism. The Symposium also included a summary of current thought on management of hyperlipemias and atherosclerosis. Data on more than 30 drugs were introduced and discussed. We have every expectation that the next Symposium will include material which is now only in the formative stage. The Organizing Committee would like to acknowledge the invaluable assistance of Miss Mary Constant, Mr. Ralph H. Hollerorth, Mrs. Carolyn P. Hyatt and Miss Jane T. Kolimaga, whose efforts contributed significantly (p
Even a brief scan of the table of contents of the present volume is enough to disclose the diversity of research interests and opinions in the field of lipidology. It is precisely this diversity that is the strength of our field and that was showcased by the XII International Symposium of DRUGS AFFECTING LIPID METABOLISM (DALM). The papers published here from these proceedings may be divided into three categories: those that define-and refine---our understanding ofthe clinical benefit of aggressive lipid management, those that develop our knowledge of ris!. assessment, and those that discuss the genetic, bio~hemical, and biophysical mechanisms underlying the pathology of coronary heart disease. On the clinical front, further analysis of the results of the Scandinavian Simvastatin Survival Study (4S) has indicated the cost-effectiveness of therapy in patients with established coronary heart disease. The West of Scotland Coronary Prevention Study (WOSCOPS), whose methodology was described at the DALM XII symposium, has demonstrated in a mostly primary-prevention population what 4S demonstrated for secondary prevention the year before: aggressive lipid-regulating therapy reduces coronary heart disease morbidity and mortality rates without concurrently increasing mortality from noncardiovascular causes. In the future, important considerations will be to develop protocols that maximize benefit in groups underrepresented in traditional clinical research for example, women and the elderly-and to improve compliance to existing treatment regimens. Furthermore, antioxidant, omega-3 fatty acid, and gene therapies warrant further investigation.