Influence of nicotinic acid, niceritrol and beta-pyridylcarbinol on experimental hyperlipidemia and atherosclerosis in mini-pigs

Therapeutic Potential of Emerging NAD+-Increasing Strategies for Cardiovascular Diseases

Cardiovascular diseases are the leading cause of death worldwide. Aging and/or metabolic stress directly impact the cardiovascular system. Over the last few years, the contributions of altered nicotinamide adenine dinucleotide (NAD+) metabolism to aging and other pathological conditions closely related to cardiovascular diseases have been intensively investigated. NAD+ bioavailability decreases with age and cardiometabolic conditions in several mammalian tissues. Compelling data suggest that declining tissue NAD+ is commonly related to mitochondrial dysfunction and might be considered as a therapeutic target. Thus, NAD+ replenishment by either genetic or natural dietary NAD+-increasing strategies has been recently demonstrated to be effective for improving the pathophysiology of cardiac and vascular health in different experimental models, as well as human health, to a lesser extent. Here, we review and discuss recent experimental evidence illustrating that increasing NAD+ bioavailability, particularly by the use of natural NAD+ precursors, may offer hope for new therapeutic strategies to prevent and treat cardiovascular diseases.

Nicotinic acid and DP1 blockade: studies in mouse models of atherosclerosis

The use of nicotinic acid to treat dyslipidemia is limited by induction of a "flushing" response, mediated in part by the interaction of prostaglandin D(2) (PGD(2)) with its G-protein coupled receptor, DP1 (Ptgdr). The impact of DP1 blockade (genetic or pharmacologic) was assessed in experimental murine models of atherosclerosis. In Ptgdr(-/-)ApoE(-/-) mice versus ApoE(-/-) mice, both fed a high-fat diet, aortic cholesterol content was modestly higher (1.3- to 1.5-fold, P < 0.05) in Ptgdr(-/-)ApoE(-/-) mice at 16 and 24 weeks of age, but not at 32 weeks. In multiple ApoE(-/-) mouse studies, a DP1-specific antagonist, L-655, generally had a neutral to beneficial effect on aortic lipids in the presence or absence of nicotinic acid treatment. In a separate study, a modest increase in some atherosclerotic measures was observed with L-655 treatment in Ldlr(-/-) mice fed a high-fat diet for 8 weeks; however, this effect was not sustained for 16 or 24 weeks. In the same study, treatment with nicotinic acid alone generally decreased plasma and/or aortic lipids, and addition of L-655 did not negate those beneficial effects. These studies demonstrate that inhibition of DP1, with or without nicotinic acid treatment, does not lead to consistent or sustained effects on plaque burden in mouse atherosclerotic models.

Niacin attenuates lung inflammation and improves survival during sepsis by downregulating the nuclear factor-κB pathway

OBJECTIVES

To examine whether niacin attenuates lung inflammation and improves survival during sepsis and to determine whether the beneficial effects of niacin are associated with downregulation of the nuclear factor (NF)-κB pathway.

DESIGN

Prospective laboratory study.

SETTING

University laboratory.

SUBJECTS

Male Sprague-Dawley rats (n = 119).

INTERVENTIONS

To induce endotoxemia in rats, lipopolysaccharide (Escherichia coli, O26:B6) at a dosage of 10 mg/kg was injected into a tail vein and 10 mins later, vehicle, a low dose of niacin (360 mg/kg), or a high dose of niacin (1180 mg/kg) was administered once through an orogastric tube, respectively.

MEASUREMENTS AND MAIN RESULTS

We observed the survival of the subjects for 72 hrs. At 6 hrs postlipopolysaccharide, we euthanized animals and measured cytoplasmic phosphorylated inhibitor κB-α and inhibitor κB-α expressions, nuclear NF-κB p65 expression, NF-κB p65 DNA-binding activity, tumor necrosis factor-α, and interleukin-6 gene expressions and histologic damages in lung tissues. We also measured nicotinamide adenine dinucleotide, reduced nicotinamide adenine dinucleotide phosphate, reduced glutathione, and malondialdehyde levels in lung tissues. High dose of niacin suppressed NF-κB activation and proinflammatory cytokine gene expressions in lung tissues, reduced histologic lung damages, and improved survival in endotoxemic rats. Furthermore, it increased nicotinamide adenine dinucleotide, nicotinamide adenine dinucleotide phosphate, and glutathione levels and decreased malondialdehyde level in lung tissues.

CONCLUSIONS

High dose of niacin attenuated lung inflammation, reduced histologic lung damages, and improved survival during sepsis in rats. These therapeutic benefits were associated with downregulation of the NF-κB pathway.

Nicotinic acid inhibits progression of atherosclerosis in mice through its receptor GPR109A expressed by immune cells

Nicotinic acid (niacin) is a drug used to reduce the progression of atherosclerosis. Its antiatherosclerotic activity is believed to result from lipid-modifying effects, including its ability to decrease LDL cholesterol and increase HDL cholesterol levels in plasma. Here, we report that in a mouse model of atherosclerosis, we found that nicotinic acid inhibited disease progression under conditions that left total cholesterol and HDL cholesterol plasma levels unaffected. The antiatherosclerotic effect was not seen in mice lacking the receptor for nicotinic acid GPR109A. Surprisingly, transplantation of bone marrow from GPR109A-deficient mice into atherosclerosis-prone animals also abrogated the beneficial effect of nicotinic acid. We detected expression of GPR109A in macrophages in atherosclerotic plaques. In macrophages from WT mice, but not from GPR109A-deficient animals, nicotinic acid induced expression of the cholesterol transporter ABCG1 and promoted cholesterol efflux. Furthermore, activation of GPR109A by nicotinic acid inhibited MCP-1-induced recruitment of macrophages into the peritoneal cavity and impaired macrophage recruitment to atherosclerotic plaques. In contrast with current models, our data show that nicotinic acid can reduce the progression of atherosclerosis independently of its lipid-modifying effects through the activation of GPR109A on immune cells. We conclude therefore that GPR109A mediates antiinflammatory effects, which may be useful for treating atherosclerosis and other diseases.

Angiotensin converting anzyme (ACE) activity in porcine ocular tissue: effects of diet and ACE inhibitors

The aim of the present experiments was to determine angiotensin converting enzyme (ACE) activity in different parts of the porcine eye, and to examine whether an atherogenic diet influenced ACE activity. Female mini-pigs were fed a standard diet or a diet with high cholesterol to produce atherosclerosis. The animals were killed by an overdose of pentobarbital, and the eyes were enucleated and dissected into iris, ciliary body, retina, and choroid. Crude tissue homogenates were used for determination of ACE activity, which was done with a radioenzymatic assay. In pigs fed a normal diet, basal ACE activity was 18.1 +/- 1.6, 13.6 +/- 1.9, 4.4 +/- 0.6, and 44.7 +/- 8.5 units/mg for iris, ciliary body, retina, and choroid, respectively. The ACE activities in ocular tissues from the pigs that had been fed an atherogenic diet were not significantly different. Nor was the ACE activity in the abdominal aorta and serum significantly different between the two groups. In both groups, the ACE inhibitors captopril and enalaprilat, caused a significant inhibition of the ACE activity in the choroid and ciliary body, with enalaprilat being more potent. In the retina, ACE activity was inhibited significantly only in the group fed a normal diet, whereas ACE activity in the iris was not significantly inhibited in either group. We did not find any differences in ACE activity between pigs fed a normal diet and pigs fed an atherogenic diet, which is in disagreement with previous studies that showed an increased ACE activity in aorta from atherosclerotic mini-pigs. The reason for this discrepancy is not clear, but lower cholesterol levels are one possibility.

Atherosclerosis: the importance of HDL cholesterol and prostacyclin: a role for niacin therapy

Niacin reduces the incidence of non-fatal myocardial way infarction, confers a significant long-term survival benefit after recovery from myocardial infarction, and has had many years of study and usage by the medical community. Recent evidence suggests that via mechanisms which elevate HDL cholesterol and also release endogenous prostacyclin, niacin should be a potent agent in the long-term treatment of atherosclerosis.

The influence of atenolol and prazosin on serum lipids and atherosclerosis in minipigs fed a hyperlipidemic diet

1. The effect of the adrenergic blockers prazosin and atenolol were tested in hypercholesterolemic Göttingen minipigs. 2. After 1 yr there was a significant reduction of plasma triglycerides and total cholesterol in the medicated animals as compared to untreated ones. 3. No significant difference in atherosclerotic lesions was observed.

Influence of clofibrate on the plasma lipoprotein pattern and on the lipid content and protein and collagen synthesis in atherosclerotic coronary arteries and abdominal aorta from hypercholesterolemic mini-pigs

The influence of clofibrate on the plasma lipoprotein pattern in hyperlipidemic mini-pigs was studied and an attempt was made to characterize the type of atherosclerosis produced in this animal model. Thirty-two female mini-pigs of the Göttingen strain were used. Experimental hypercholesterolemia and atherosclerosis were produced in 16 of the animals by adding 11.2% egg yolk and 0.5% cholesterol to the diet for 14 months. In groups of 8 normolipidemic and 8 hyperlipidemic animals clofibrate was added in a dose of 2 g per animal and day. The remaining 8 animals of each category served as controls. Two months of clofibrate treatment normalized the plasma cholesterol in the hyperlipidemic group mainly by reducing the elevated LDL-cholesterol fraction. In normolipidemic animals clofibrate significantly reduced the HDL-cholesterol. At the end of the treatment period the animals were slaughtered and autopsied. The right coronary artery and normal and atherosclerotic pieces of the abdominal aorta were taken for biochemical analysis. There was a marked accumulation of free and esterified cholesterol in the right coronary artery from hyperlipidemic animals. Clofibrate treatment significantly reduced the content of esterified cholesterol in this vessel. Atherosclerotic pieces from the abdominal aorta were also rich in free and esterified cholesterol and showed a higher rate of proline and hydroxyproline incorporation than the adjacent normal tissue. The contents of proline and hydroxyproline were relatively unchanged, however, suggesting that there may be an increased turnover of protein and collagen synthesis rather than an increased total protein and collagen production.(ABSTRACT TRUNCATED AT 250 WORDS)

Antihyperlipidemic properties of beta-pyridylcarbinol. A review of preclinical studies

The available preclinical literature on the antihyperlipidemic properties of beta-pyridylcarbinol is reviewed. Similarities between the pharmacological profiles for beta-pyridylcarbinol and nicotinic acid, and evidence for the metabolic conversion of beta-pyridylcarbinol to nicotinic acid are discussed. Several reviews discussing the antihyperlipidemic effects of beta-pyridylcarbinol (beta-PC, nicotinyl alcohol, Roniacol) and nicotinic acid (NA) have appeared during the last 15 years (1-6). However, continuing clinical interest in the ability of nicotinic acid analogs to reduce plasma lipids indicated that an update and critical evaluation of the preclinical literature on this subject would be of value in order to permit a more complete assessment of the relevance of several animal models to effects in human subjects. The literature reviewed included (a) preclinical studies of beta-PC where it was the sole compound examined; (b) comparative studies of beta-PC and NA; and (c) studies relating to the metabolism of beta-PC. The literature chosen included experiments involving fasted animals, satiated animals, and effects of Triton-induced hyperlipidemia. Data on other pharmacological properties of beta-PC and/or NA that might contribute to antihyperlipidemic efficacy (e.g., fibrinolysis, inhibition of platelet aggregation, erythrocyte membrane changes) were also included where available.

Sudden death related to advanced coronary atherosclerosis in mini-pigs: influence of some drugs

Advanced coronary atherosclerosis was produced in 30 mini-pigs by a combination of a hypercholesterolaemic diet and X-irradiation to the precordial region. Within 11-25 weeks after the irradiation, 13 of the 30 animals died a sudden death probably caused by coronary atherosclerosis. The contents of free and ester-bound cholesterol in the right coronary artery were significantly higher in the animals which died spontaneously than in surviving animals. In an untreated group of 12 animals 7 died whereas in a group treated with beta-pyridylcarbinol only 1 out of 5 died. In the coronary arteries, the contents of both free and ester-bound cholesterol were significantly lower in the beta-pyridylcarbinol-treated animals. In a sulfinpyrazone-treated group 3 out of 8, and in a metoprolol-treated group 2 out of 5 animals died. None of these drugs reduced the accumulation of cholesterol in the coronary arteries. The rate of sudden death was 26 +/- 6% (P less than 0.05) lower in the combined group of treated animals than in the untreated ones. By regular ECG recordings, signs which could predict the fatal outcome of the experiment were looked for. Although depressed ST segments were present before death in a few animals, this was not a regular phenomenon. It is concluded that advanced coronary atherosclerosis in mini-pigs often leads to sudden death and that this animal model seems suitable for testing the potential therapeutic effects of drugs.

Comparative evaluation of some pharmacological properties and side effects of D-glucitol hexanicotinate (sorbinicate) and nicotinic acid correlated with the plasma concentration of nicotinic acid

In rabbits kept on a diet containing 1 g/day cholesterol for 12 weeks, the nicotinic acid derivative sorbinicate displayed greater hypolipemic and antiatherogenic activity than an equidose of plain nicotinic acid at much lower and more constant plasma nicotinic acid levels. In normocholesterolemic rats, nicotinic acid given at a level of 300 mg/kg per dose for 3 weeks induced plasma FFA and triglyceride rebound and triglyceride accumulation in the liver and possibly in the heart (all parameters determined 24 h after the last dosing), whereas an equidose of sorbinicate was free from these effects, potentially the two most dangerous side effects of nicotinic acid. By modulating the bioavailability of nicotinic acid, sorbinicate maintains and in some cases enhances the pharmacological activity of the acid, avoiding at least some of its major side effects.