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Zhen J, Li X, Yu H, Du B. High-density lipoprotein mimetic nano-therapeutics targeting monocytes and macrophages for improved cardiovascular care: a comprehensive review. J Nanobiotechnology 2024; 22:263. [PMID: 38760755 PMCID: PMC11100215 DOI: 10.1186/s12951-024-02529-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 05/03/2024] [Indexed: 05/19/2024] Open
Abstract
The prevalence of cardiovascular diseases continues to be a challenge for global health, necessitating innovative solutions. The potential of high-density lipoprotein (HDL) mimetic nanotherapeutics in the context of cardiovascular disease and the intricate mechanisms underlying the interactions between monocyte-derived cells and HDL mimetic showing their impact on inflammation, cellular lipid metabolism, and the progression of atherosclerotic plaque. Preclinical studies have demonstrated that HDL mimetic nanotherapeutics can regulate monocyte recruitment and macrophage polarization towards an anti-inflammatory phenotype, suggesting their potential to impede the progression of atherosclerosis. The challenges and opportunities associated with the clinical application of HDL mimetic nanotherapeutics, emphasize the need for additional research to gain a better understanding of the precise molecular pathways and long-term effects of these nanotherapeutics on monocytes and macrophages to maximize their therapeutic efficacy. Furthermore, the use of nanotechnology in the treatment of cardiovascular diseases highlights the potential of nanoparticles for targeted treatments. Moreover, the concept of theranostics combines therapy and diagnosis to create a selective platform for the conversion of traditional therapeutic medications into specialized and customized treatments. The multifaceted contributions of HDL to cardiovascular and metabolic health via highlight its potential to improve plaque stability and avert atherosclerosis-related problems. There is a need for further research to maximize the therapeutic efficacy of HDL mimetic nanotherapeutics and to develop targeted treatment approaches to prevent atherosclerosis. This review provides a comprehensive overview of the potential of nanotherapeutics in the treatment of cardiovascular diseases, emphasizing the need for innovative solutions to address the challenges posed by cardiovascular diseases.
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Affiliation(s)
- Juan Zhen
- The First Hospital of Jilin University, Changchun, 130021, China
| | - Xiangjun Li
- School of Pharmaceutical Science, Jilin University, Changchun, 130021, China
| | - Haitao Yu
- The First Hospital of Jilin University, Changchun, 130021, China
| | - Bing Du
- The First Hospital of Jilin University, Changchun, 130021, China.
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Rani A, Marsche G. A Current Update on the Role of HDL-Based Nanomedicine in Targeting Macrophages in Cardiovascular Disease. Pharmaceutics 2023; 15:1504. [PMID: 37242746 PMCID: PMC10221824 DOI: 10.3390/pharmaceutics15051504] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
High-density lipoproteins (HDL) are complex endogenous nanoparticles involved in important functions such as reverse cholesterol transport and immunomodulatory activities, ensuring metabolic homeostasis and vascular health. The ability of HDL to interact with a plethora of immune cells and structural cells places it in the center of numerous disease pathophysiologies. However, inflammatory dysregulation can lead to pathogenic remodeling and post-translational modification of HDL, rendering HDL dysfunctional or even pro-inflammatory. Monocytes and macrophages play a critical role in mediating vascular inflammation, such as in coronary artery disease (CAD). The fact that HDL nanoparticles have potent anti-inflammatory effects on mononuclear phagocytes has opened new avenues for the development of nanotherapeutics to restore vascular integrity. HDL infusion therapies are being developed to improve the physiological functions of HDL and to quantitatively restore or increase the native HDL pool. The components and design of HDL-based nanoparticles have evolved significantly since their initial introduction with highly anticipated results in an ongoing phase III clinical trial in subjects with acute coronary syndrome. The understanding of mechanisms involved in HDL-based synthetic nanotherapeutics is critical to their design, therapeutic potential and effectiveness. In this review, we provide a current update on HDL-ApoA-I mimetic nanotherapeutics, highlighting the scope of treating vascular diseases by targeting monocytes and macrophages.
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Affiliation(s)
- Alankrita Rani
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria;
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
| | - Gunther Marsche
- Division of Pharmacology, Otto Loewi Research Center, Medical University of Graz, Neue Stiftingtalstrasse 6, 8010 Graz, Austria;
- BioTechMed-Graz, Mozartgasse 12/II, 8010 Graz, Austria
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3
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Liu JD, Gong R, Zhang SY, Zhou ZP, Wu YQ. Beneficial effects of high-density lipoprotein (HDL) on stent biocompatibility and the potential value of HDL infusion therapy following percutaneous coronary intervention. Medicine (Baltimore) 2022; 101:e31724. [PMID: 36397406 PMCID: PMC9666103 DOI: 10.1097/md.0000000000031724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Several epidemiological studies have shown a clear inverse relationship between serum levels of high-density lipoprotein cholesterol (HDL-C) and the risk of atherosclerotic cardiovascular disease (ASCVD), even at low-density lipoprotein cholesterol levels below 70 mg/dL. There is much evidence from basic and clinical studies that higher HDL-C levels are beneficial, whereas lower HDL-C levels are detrimental. Thus, HDL is widely recognized as an essential anti-atherogenic factor that plays a protective role against the development of ASCVD. Percutaneous coronary intervention is an increasingly common treatment choice to improve myocardial perfusion in patients with ASCVD. Although drug-eluting stents have substantially overcome the limitations of conventional bare-metal stents, there are still problems with stent biocompatibility, including delayed re-endothelialization and neoatherosclerosis, which cause stent thrombosis and in-stent restenosis. According to numerous studies, HDL not only protects against the development of atherosclerosis, but also has many anti-inflammatory and vasoprotective properties. Therefore, the use of HDL as a therapeutic target has been met with great interest. Although oral medications have not shown promise, the developed HDL infusions have been tested in clinical trials and have demonstrated viability and reproducibility in increasing the cholesterol efflux capacity and decreasing plasma markers of inflammation. The aim of the present study was to review the effect of HDL on stent biocompatibility in ASCVD patients following implantation and discuss a novel therapeutic direction of HDL infusion therapy that may be a promising candidate as an adjunctive therapy to improve stent biocompatibility following percutaneous coronary intervention.
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Affiliation(s)
- Jian-Di Liu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Ren Gong
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Shi-Yuan Zhang
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Zhi-Peng Zhou
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
| | - Yan-Qing Wu
- Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Nanchang, Jiangxi, China
- * Correspondence: Yan-Qing Wu, Department of Cardiology, The Second Affiliated Hospital of Nanchang University, Minde Road No. 1, Nanchang, Jiangxi 330006, China (e-mail: )
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4
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Murphy AJ, Febbraio MA. Immune-based therapies in cardiovascular and metabolic diseases: past, present and future. Nat Rev Immunol 2021; 21:669-679. [PMID: 34285393 DOI: 10.1038/s41577-021-00580-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/08/2021] [Indexed: 02/02/2023]
Abstract
Cardiometabolic disorders were originally thought to be driven primarily by changes in lipid metabolism that cause the accumulation of lipids in organs, thereby impairing their function. Thus, in the setting of cardiovascular disease, statins - a class of lipid-lowering drugs - have remained the frontline therapy. In the past 20 years, seminal discoveries have revealed a central role of both the innate and adaptive immune system in driving cardiometabolic disorders. As such, it is now appreciated that immune-based interventions may have an important role in reducing death and disability from cardiometabolic disorders. However, to date, there have been a limited number of clinical trials exploring this interventional strategy. Nonetheless, elegant preclinical research suggests that immune-targeted therapies can have a major impact in treating cardiometabolic disease. Here, we discuss the history and recent advancements in the use of immunotherapies to treat cardiometabolic disorders.
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Affiliation(s)
- Andrew J Murphy
- Baker Heart & Diabetes Institute, Melbourne, Victoria, Australia.
| | - Mark A Febbraio
- Monash Institute of Pharmaceutical Sciences, Monash University, Parkville, Victoria, Australia.
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5
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Wolska A, Reimund M, Sviridov DO, Amar MJ, Remaley AT. Apolipoprotein Mimetic Peptides: Potential New Therapies for Cardiovascular Diseases. Cells 2021; 10:597. [PMID: 33800446 PMCID: PMC8000854 DOI: 10.3390/cells10030597] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Revised: 03/01/2021] [Accepted: 03/02/2021] [Indexed: 12/13/2022] Open
Abstract
Since the seminal breakthrough of treating diabetic patients with insulin in the 1920s, there has been great interest in developing other proteins and their peptide mimetics as therapies for a wide variety of other medical disorders. Currently, there are at least 60 different peptides that have been approved for human use and over 150 peptides that are in various stages of clinical development. Peptides mimetic of the major proteins on lipoproteins, namely apolipoproteins, have also been developed first as tools for understanding apolipoprotein structure and more recently as potential therapeutics. In this review, we discuss the biochemistry, peptide mimetics design and clinical trials for peptides based on apoA-I, apoE and apoC-II. We primarily focus on applications of peptide mimetics related to cardiovascular diseases. We conclude with a discussion on the limitations of peptides as therapeutic agents and the challenges that need to be overcome before apolipoprotein mimetic peptides can be developed into new drugs.
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Affiliation(s)
- Anna Wolska
- Lipoprotein Metabolism Laboratory, Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD 20892, USA; (M.R.); (D.O.S.); (M.J.A.); (A.T.R.)
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Montarello NJ, Nelson AJ, Verjans J, Nicholls SJ, Psaltis PJ. The role of intracoronary imaging in translational research. Cardiovasc Diagn Ther 2020; 10:1480-1507. [PMID: 33224769 DOI: 10.21037/cdt-20-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Atherosclerotic cardiovascular disease is a key public health concern worldwide and leading cause of morbidity, mortality and health economic costs. Understanding atherosclerotic plaque microstructure in relation to molecular mechanisms that underpin its initiation and progression is needed to provide the best chance of combating this disease. Evolving vessel wall-based, endovascular coronary imaging modalities, including intravascular ultrasound (IVUS), optical coherence tomography (OCT) and near-infrared spectroscopy (NIRS), used in isolation or as hybrid modalities, have been advanced to allow comprehensive visualization of the pathological substrate of coronary atherosclerosis and accurately measure temporal changes in both the vessel wall and plaque characteristics. This has helped further our appreciation of the natural history of coronary artery disease (CAD) and the risk for major adverse cardiovascular events (MACE), evaluate the responsiveness to conventional and experimental therapeutic interventions, and assist in guiding percutaneous coronary intervention (PCI). Here we review the use of different imaging modalities for these purposes and the lessons they have provided thus far.
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Affiliation(s)
- Nicholas J Montarello
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia
| | - Adam J Nelson
- Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Duke Clinical Research Institute, Durham, NC, USA
| | - Johan Verjans
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
| | - Stephen J Nicholls
- Monash Cardiovascular Research Centre, Monash University, Clayton, Australia
| | - Peter J Psaltis
- Department of Cardiology, Central Adelaide Local Health Network, Adelaide, Australia.,Adelaide Medical School, University of Adelaide, Adelaide, Australia.,Vascular Research Centre, Heart and Vascular Program, Lifelong Health Theme, South Australian Health and Medical Research Institute, Adelaide, Australia
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7
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Kilic ID, Fabris E, Kedhi E, Ghilencea LN, Caiazzo G, Sherif SA, Di Mario C. Intra-coronary Imaging for the Evaluation of Plaque Modifications Induced by Drug Therapies for Secondary Prevention. Curr Atheroscler Rep 2020; 22:76. [PMID: 33025069 PMCID: PMC7538414 DOI: 10.1007/s11883-020-00890-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/16/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE OF REVIEW Patients diagnosed with coronary artery disease are at a high risk of subsequent cardiovascular events; therefore, secondary prevention in the form of therapeutic lifestyle changes, and drug therapies is vital. This article aims to review potential application of intra-coronary imaging for the evaluation of plaque modifications, induced by medications for secondary prevention for CAD. RECENT FINDINGS Intra-coronary imaging provides detailed information on the atherosclerotic plaque which is the primary pathological substrate for the recurrent ischemic cardiovascular events. These modalities can detect features associated with high risk and allow serial in vivo imaging of lesions. Therefore, intravascular imaging tools have been used in landmark studies and played a role in improving our understanding of the disease processes. Changes in size and plaque composition over time can be evaluated by these tools and may help understanding the impact of a treatment. Moreover, surrogate imaging end points can be used when testing new drugs for secondary prevention.
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Affiliation(s)
- Ismail Dogu Kilic
- Department of Cardiology, Pamukkale University Hospitals, Denizli, Turkey
| | - Enrico Fabris
- Cardiovascular Department, University of Trieste, Trieste, Italy
| | - Elvin Kedhi
- Department of Cardiology, Isala Heart Center, Zwolle, the Netherlands
| | | | | | | | - Carlo Di Mario
- Cardio-toraco-vascular Department, Careggi University Hospital, Florence, Italy
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8
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Adawi M, Sabbah F, Tzischinsky O, Blum N, Bragazzi NL, Yehuda I, Tamir S, Romanenko O, Blum A. Sleep disorders and vascular responsiveness in patients with rheumatoid arthritis. J Intern Med 2020; 288:439-445. [PMID: 32330326 DOI: 10.1111/joim.13087] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Accepted: 04/08/2020] [Indexed: 01/13/2023]
Abstract
BACKGROUND Rheumatoid arthritis (RA) is the most common systemic autoimmune disease characterized by chronic systemic inflammation. Half of the deaths of patients with RA are due to cardiovascular diseases (CVD), considered to be 1.5 to -2.0-fold that in the general population. Patients with RA also experience poor sleep, which by itself is associated with endothelial dysfunction, CVD events and sudden death. Our aim was to study the mechanistic pathways and the correlations between sleep efficiency and vascular reactivity of patients with RA. METHODS AND RESULTS A prospective study that evaluated quality of sleep using ACTi Graphs, vascular inflammation and endothelial function of 18 patients with RA. Inflammation was studied by levels of E-selectin, intercellular adhesion molecule 1 (ICAM-1) and NO in serum. Endothelial function was studied using the brachial artery plethysmography method. Eighteen RA patients (aged 57.56 ± 13.55 years; 16 women) with a long-standing active RA: Eight patients had impaired sleep efficiency and 10 had a good sleep efficiency. Those who had an impaired sleep had larger baseline diameters of the brachial artery (0.39 ± 0.08 cm vs. 0.32 ± 0.04 cm; P = 0.02). Negative correlations were found between baseline brachial artery diameter and sleep efficiency (P = 0.01), and with NO level (P = 0.04). Stepwise regression found that brachial artery diameter at baseline and NO level could predict sleep efficiency (r2 = 0.543, P = 0.01). CONCLUSION Vascular reactivity could predict quality of sleep in patients with RA. Quality of sleep may serve as an independent CVD risk factor in patients with RA.
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Affiliation(s)
- M Adawi
- From the, Department of Medicine, the Rheumatology Unit, Azrieli Faculty of Medicine, Baruch Padeh Medical Center, Lower Galilee, Israel
| | - F Sabbah
- From the, Department of Medicine, the Rheumatology Unit, Azrieli Faculty of Medicine, Baruch Padeh Medical Center, Lower Galilee, Israel
| | - O Tzischinsky
- Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - N Blum
- Max Stern Academic College of Emek Yezreel, Emek Yezreel, Israel
| | - N L Bragazzi
- Department of Health Sciences, School of Public Health, University of Genoa, Genoa, Italy
| | - I Yehuda
- Department of Nutrition Sciences & MIGAL, Galilee Technology Center, Tel-Hai Academic College, Kiryat Shmona, Israel
| | - S Tamir
- Department of Nutrition Sciences & MIGAL, Galilee Technology Center, Tel-Hai Academic College, Kiryat Shmona, Israel
| | - O Romanenko
- Department of Nutrition Sciences & MIGAL, Galilee Technology Center, Tel-Hai Academic College, Kiryat Shmona, Israel
| | - A Blum
- From the, Department of Medicine, the Rheumatology Unit, Azrieli Faculty of Medicine, Baruch Padeh Medical Center, Lower Galilee, Israel.,Azrieli Faculty of Medicine, Vascular Biology Center, Baruch Padeh Medical Center, Bar-Ilan University, Ramat Gan, Israel
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9
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Wang D, Yang Y, Lei Y, Tzvetkov NT, Liu X, Yeung AWK, Xu S, Atanasov AG. Targeting Foam Cell Formation in Atherosclerosis: Therapeutic Potential of Natural Products. Pharmacol Rev 2019; 71:596-670. [PMID: 31554644 DOI: 10.1124/pr.118.017178] [Citation(s) in RCA: 114] [Impact Index Per Article: 22.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Foam cell formation and further accumulation in the subendothelial space of the vascular wall is a hallmark of atherosclerotic lesions. Targeting foam cell formation in the atherosclerotic lesions can be a promising approach to treat and prevent atherosclerosis. The formation of foam cells is determined by the balanced effects of three major interrelated biologic processes, including lipid uptake, cholesterol esterification, and cholesterol efflux. Natural products are a promising source for new lead structures. Multiple natural products and pharmaceutical agents can inhibit foam cell formation and thus exhibit antiatherosclerotic capacity by suppressing lipid uptake, cholesterol esterification, and/or promoting cholesterol ester hydrolysis and cholesterol efflux. This review summarizes recent findings on these three biologic processes and natural products with demonstrated potential to target such processes. Discussed also are potential future directions for studying the mechanisms of foam cell formation and the development of foam cell-targeted therapeutic strategies.
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Affiliation(s)
- Dongdong Wang
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Yang Yang
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Yingnan Lei
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Nikolay T Tzvetkov
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Xingde Liu
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Andy Wai Kan Yeung
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Suowen Xu
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
| | - Atanas G Atanasov
- The Second Affiliated Hospital of Guizhou University of Traditional Chinese Medicine, Guiyang, China (D.W., X.L.); Department of Molecular Biology, Institute of Genetics and Animal Breeding of the Polish Academy of Sciences, Jastrzębiec, Poland (D.W., Y.Y., Y.L., A.G.A.); Department of Pharmacognosy, University of Vienna, Vienna, Austria (A.G.A.); Institute of Clinical Chemistry, University Hospital Zurich, Schlieren, Switzerland (D.W.); Institute of Molecular Biology "Roumen Tsanev," Department of Biochemical Pharmacology and Drug Design, Bulgarian Academy of Sciences, Sofia, Bulgaria (N.T.T.); Pharmaceutical Institute, University of Bonn, Bonn, Germany (N.T.T.); Aab Cardiovascular Research Institute, Department of Medicine, University of Rochester, Rochester, New York (S.X.); Oral and Maxillofacial Radiology, Applied Oral Sciences and Community Dental Care, Faculty of Dentistry, The University of Hong Kong, Hong Kong, China (A.W.K.Y.); and Institute of Neurobiology, Bulgarian Academy of Sciences, Sofia, Bulgaria (A.G.A.)
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10
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Parolini C. A Compendium of the Biological Effects of Apolipoprotein A-IMilano. J Pharmacol Exp Ther 2019; 372:54-62. [DOI: 10.1124/jpet.119.261719] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2019] [Accepted: 10/22/2019] [Indexed: 12/17/2022] Open
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11
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Pirillo A, Catapano AL, Norata GD. Biological Consequences of Dysfunctional HDL. Curr Med Chem 2019; 26:1644-1664. [PMID: 29848265 DOI: 10.2174/0929867325666180530110543] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2017] [Revised: 12/25/2017] [Accepted: 12/27/2017] [Indexed: 12/31/2022]
Abstract
Epidemiological studies have suggested an inverse correlation between high-density lipoprotein (HDL) cholesterol levels and the risk of cardiovascular disease. HDLs promote reverse cholesterol transport (RCT) and possess several putative atheroprotective functions, associated to the anti-inflammatory, anti-thrombotic and anti-oxidant properties as well as to the ability to support endothelial physiology. The assumption that increasing HDL-C levels would be beneficial on cardiovascular disease (CVD), however, has been questioned as, in most clinical trials, HDL-C-raising therapies did not result in improved cardiovascular outcomes. These findings, together with the observations from Mendelian randomization studies showing that polymorphisms mainly or solely associated with increased HDL-C levels did not decrease the risk of myocardial infarction, shift the focus from HDL-C levels toward HDL functional properties. Indeed, HDL from atherosclerotic patients not only exhibit impaired atheroprotective functions but also acquire pro-atherogenic properties and are referred to as "dysfunctional" HDL; this occurs even in the presence of normal or elevated HDL-C levels. Pharmacological approaches aimed at restoring HDL functions may therefore impact more significantly on CVD outcome than drugs used so far to increase HDL-C levels. The aim of this review is to discuss the pathological conditions leading to the formation of dysfunctional HDL and their role in atherosclerosis and beyond.
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Affiliation(s)
- Angela Pirillo
- Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy.,IRCCS Multimedica, Milan, Italy
| | - Alberico Luigi Catapano
- IRCCS Multimedica, Milan, Italy.,Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy
| | - Giuseppe Danilo Norata
- Center for the Study of Atherosclerosis, Bassini Hospital, Cinisello Balsamo, Italy.,Department of Pharmacological and Biomolecular Sciences, Università degli Studi di Milano, Milan, Italy.,School of Biomedical Sciences, Curtin Health Innovation Research Institute, Curtin University, Perth, Western Australia
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12
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Filippatos TD, Liontos A, Christopoulou EC, Elisaf MS. Novel Hypolipidaemic Drugs: Mechanisms of Action and Main Metabolic Effects. Curr Vasc Pharmacol 2019; 17:332-340. [DOI: 10.2174/1570161116666180209112351] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2018] [Revised: 06/14/2018] [Accepted: 06/14/2018] [Indexed: 02/07/2023]
Abstract
Over the last 3 decades, hypolipidaemic treatment has significantly reduced both Cardiovascular
(CV) risk and events, with statins being the cornerstone of this achievement. Nevertheless, residual
CV risk and unmet goals in hypolipidaemic treatment make novel options necessary. Recently marketed
monoclonal antibodies against proprotein convertase subtilisin/kexin type 9 (PCSK9) have shown
the way towards innovation, while other ways of PCSK9 inhibition like small interfering RNA (Inclisiran)
are already being tested. Other effective and well tolerated drugs affect known paths of lipid
synthesis and metabolism, such as bempedoic acid blocking acetyl-coenzyme A synthesis at a different
level than statins, pemafibrate selectively acting on peroxisome proliferator-activated receptor (PPAR)-
alpha receptors and oligonucleotides against apolipoprotein (a). Additionally, other novel hypolipidaemic
drugs are in early phase clinical trials, such as the inhibitors of apolipoprotein C-III, which is located
on triglyceride (TG)-rich lipoproteins, or the inhibitors of angiopoietin-like 3 (ANGPTL3), which
plays a key role in lipid metabolism, aiming to beneficial effects on TG levels and glucose metabolism.
Among others, gene therapy substituting the loss of essential enzymes is already used for Lipoprotein
Lipase (LPL) deficiency in autosomal chylomicronaemia and is expected to eliminate the lack of Low-
Density Lipoprotein (LDL) receptors in patients with homozygous familial hypercholesterolaemia. Experimental
data of High-Density Lipoprotein (HDL) mimetics infusion therapy have shown a beneficial
effect on atherosclerotic plaques. Thus, many novel hypolipidaemic drugs targeting different aspects of
lipid metabolism are being investigated, although they need to be assessed in large trials to prove their
CV benefit and safety.
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Affiliation(s)
| | - Angelos Liontos
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Eliza C. Christopoulou
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
| | - Moses S. Elisaf
- Department of Internal Medicine, School of Medicine, University of Ioannina, Ioannina, Greece
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13
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Lagerstedt JO, Dalla-Riva J, Marinkovic G, Del Giudice R, Engelbertsen D, Burlin J, Petrlova J, Lindahl M, Bernfur K, Melander O, Nilsson J, Schiopu A. Anti-ApoA-I IgG antibodies are not associated with carotid artery disease progression and first-time cardiovascular events in middle-aged individuals. J Intern Med 2019; 285:49-58. [PMID: 30028049 DOI: 10.1111/joim.12817] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE IgG antibodies against apolipoprotein A-I (ApoA-I) have been found to be elevated in subjects from the general population with clinically manifest cardiovascular disease and in myocardial infarction patients with an adverse prognosis. Here, we investigated whether these antibodies are prospectively associated with carotid artery disease progression and with the risk for first-time cardiovascular events in individuals with no previous history of cardiovascular disease. APPROACH AND RESULTS We selected 383 subjects from the cardiovascular cohort of Malmö Diet and Cancer study who suffered a coronary event during a median follow-up period of 15.4 (10.3-16.4) years and 395 age- and sex-matched controls. None of the study participants had a previous history of coronary artery disease or stroke. Anti-ApoA-I IgG were measured by ELISA in serum samples collected at baseline. Intima-media thickness (IMT) was measured in the common carotid artery and in the carotid bifurcation at baseline and after 15.9 (±1.5) years. We found no associations between anti-ApoA-I IgG and carotid artery IMT at baseline or with IMT progression during follow-up. In Cox proportional hazards analyses adjusted for traditional cardiovascular risk factors, the hazard ratio (HR 95%CI) for the primary outcome, incident coronary events, was 0.97 (0.75-1.25), P = 0.782, in subjects with anti-ApoA-I IgG within the highest tertile compared with the lowest tertile. Similarly, we did not find any associations with the secondary outcome, incident first-time stroke. CONCLUSIONS Serum autoantibodies against ApoA-I do not correlate with disease progression and adverse events in cardiovascular disease-free individuals from the general population.
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Affiliation(s)
- J O Lagerstedt
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - J Dalla-Riva
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - G Marinkovic
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - R Del Giudice
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - D Engelbertsen
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - J Burlin
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - J Petrlova
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - M Lindahl
- Medical Protein Science Unit, Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - K Bernfur
- Department of Biochemistry and Structural Biology, Lund University, Lund, Sweden
| | - O Melander
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - J Nilsson
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - A Schiopu
- Department of Clinical Sciences Malmö, Lund University, Lund, Sweden.,Department of Cardiology, Skåne University Hospital Malmö, Malmö, Sweden
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14
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Theofilatos D, Fotakis P, Valanti E, Sanoudou D, Zannis V, Kardassis D. HDL-apoA-I induces the expression of angiopoietin like 4 (ANGPTL4) in endothelial cells via a PI3K/AKT/FOXO1 signaling pathway. Metabolism 2018; 87:36-47. [PMID: 29928895 DOI: 10.1016/j.metabol.2018.06.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Revised: 05/17/2018] [Accepted: 06/17/2018] [Indexed: 11/17/2022]
Abstract
BACKGROUND High Density Lipoprotein (HDL) and its main protein component, apolipoprotein A-I (apoA-I), have numerous atheroprotective functions on various tissues including the endothelium. Therapies based on reconstituted HDL containing apoA-I (rHDL-apoA-I) have been used successfully in patients with acute coronary syndrome, peripheral vascular disease or diabetes but very little is known about the genomic effects of rHDL-apoA-I and how they could contribute to atheroprotection. OBJECTIVE The present study aimed to understand the endothelial signaling pathways and the genes that may contribute to rHDL-apoA-I-mediated atheroprotection. METHODS Human aortic endothelial cells (HAECs) were treated with rHDL-apoA-I and their total RNA was analyzed with whole genome microarrays. Validation of microarray data was performed using multiplex RT-qPCR. The expression of ANGPTL4 in EA.hy926 endothelial cells was determined by RT-qPCR and Western blotting. The contribution of signaling kinases and transcription factors in ANGPTL4 gene regulation by HDL-apoA-I was assessed by RT-qPCR, Western blotting and immunofluorescence using chemical inhibitors or siRNA-mediated gene silencing. RESULTS It was found that 410 transcripts were significantly changed in the presence of rHDL-apoA-I and that angiopoietin like 4 (ANGPTL4) was one of the most upregulated and biologically relevant molecules. In validation experiments rHDL-apoA-I, as well as natural HDL from human healthy donors or from transgenic mice overexpressing human apoA-I (TgHDL-apoA-I), increased ANGPTL4 mRNA and protein levels. ANGPTL4 gene induction by HDL was direct and was blocked in the presence of inhibitors for the AKT or the p38 MAP kinases. TgHDL-apoA-I caused phosphorylation of the transcription factor forkhead box O1 (FOXO1) and its translocation from the nucleus to the cytoplasm. Importantly, a FOXO1 inhibitor or a FOXO1-specific siRNA enhanced ANGPTL4 expression, whereas administration of TgHDL-apoA-I in the presence of the FOXO1 inhibitor or the FOXO1-specific siRNA did not induce further ANGPTL4 expression. These data suggest that FOXO1 functions as an inhibitor of ANGPTL4, while HDL-apoA-I blocks FOXO1 activity and induces ANGPTL4 through the activation of AKT. CONCLUSION Our data provide novel insights into the global molecular effects of HDL-apoA-I on endothelial cells and identify ANGPTL4 as a putative mediator of the atheroprotective functions of HDL-apoA-I on the artery wall, with notable therapeutic potential.
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Affiliation(s)
- Dimitris Theofilatos
- Laboratory of Biochemistry, University of Crete School of Medicine, Heraklion, Greece; Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology of Hellas, Heraklion, Greece
| | - Panagiotis Fotakis
- Section of Molecular Genetics, Boston University Medical School, Boston, USA
| | - Efi Valanti
- 4th Department of Internal Medicine, "Attikon" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Despina Sanoudou
- 4th Department of Internal Medicine, "Attikon" Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Vassilis Zannis
- Section of Molecular Genetics, Boston University Medical School, Boston, USA
| | - Dimitris Kardassis
- Laboratory of Biochemistry, University of Crete School of Medicine, Heraklion, Greece; Institute of Molecular Biology and Biotechnology, Foundation for Research and Technology of Hellas, Heraklion, Greece.
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15
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Nicholls SJ, Tuzcu EM, Wolski K, Johnson BD, Sopko G, Sharaf BL, Pepine CJ, Nissen SE, Bairey Merz CN. Extent of coronary atherosclerosis and arterial remodelling in women: the NHLBI-sponsored Women's Ischemia Syndrome Evaluation. Cardiovasc Diagn Ther 2018; 8:405-413. [PMID: 30214855 PMCID: PMC6129832 DOI: 10.21037/cdt.2018.04.03] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Accepted: 03/16/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND Information regarding the pathogenesis of ischemic heart disease (IHD) in women is limited. Sex-specific responses to atherosclerosis and coronary arterial remodelling in women versus men have been hypothesized, but limited study exists. METHODS Case-matched study of 174 women with suspected ischemia referred for coronary angiography: 87 with non-obstructive coronary artery disease (CAD) (no luminal diameter stenosis >20% in any coronary artery) and 87 age and ethnicity matched women with obstructive CAD. Groups were compared with regard to atheroma burden and coronary arterial remodelling assessed by coronary artery intravascular ultrasound (IVUS). RESULTS IVUS revealed more extensive atheroma with obstructive CAD vs. those without obstructive CAD, with greater percent atheroma volume (PAV) (36.1%±9.8% vs. 25.4%±9.1%, P<0.0001), total atheroma volume (TAV) (140.8±58.7 vs. 98.8±46.9 mm3, P<0.0001) and percentage of images containing plaque (70.0%±30.5% vs. 35.7%±32.6%, P<0.0001). Adjusting for risk factors, PAV (35%±1% vs. 28%±1%, P=0.0008), TAV (131±7 vs. 115±7 mm3, P=0.110) and percentage of images containing plaque (66%±4% vs. 45%±5%, P=0.0008) remained greater with obstructive CAD. Obstructive CAD was associated with smaller lumen volumes (251.9±92.8 vs. 289.7±91.8 mm3, P=0.005), but surprisingly, the external elastic membrane (EEM) volume was very similar comparing the groups (392.7±128.1 vs. 388.6±113.7 mm3, P=0.910). CONCLUSIONS Our findings suggest that women referred to angiography for suspected ischemia, have differing patterns of coronary arterial response to injury with regard to accumulation of atherosclerosis and compensatory remodelling related to the presence and absence of obstructive CAD. Preservation and cultivation of compensatory arterial remodelling may be a novel CAD therapeutic target.
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Affiliation(s)
- Stephen J. Nicholls
- South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | | | | | - B. Delia Johnson
- Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - George Sopko
- National Heart, Lung, and Blood Institute, Bethesda, MD, USA
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16
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Kawashiri MA, Tada H, Nomura A, Yamagishi M. Mendelian randomization: Its impact on cardiovascular disease. J Cardiol 2018; 72:307-313. [PMID: 29801689 DOI: 10.1016/j.jjcc.2018.04.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 04/10/2018] [Indexed: 02/03/2023]
Abstract
Cardiovascular diseases and their risk factors are inheritable. Single nucleotide polymorphisms in the human genome are found in around 1 in 1000 base pairs, and this may affect the genetic variety of individuals. During meiosis, any genetic information is randomized and is independent of other characteristics. In a Mendelian randomization study (MRS), a genetic variant associated with biomarker is used as a proxy for the biomarker, and the outcomes are compared between the groups harboring the effect alleles and a group with the reference allele. An MRS using variants of both rare and modest effect sizes and variants of common and lower effect sizes provides an understanding of risk factors and their causality of cardiovascular disease; for example, an individual possessing an allele associated with lower low-density lipoprotein cholesterol (LDL-C) exhibits lower risk of coronary artery disease (CAD). Moreover, the log-transformed reduction rates of CAD are linearly correlated with the reduction value of LDL-C. High-density lipoprotein (HDL) removes cholesteryl esters from peripheral tissues, including atherosclerotic plaque to the liver. Numerous epidemiological studies have shown that HDL-cholesterol (HDL-C) levels are inversely associated with the frequency of the occurrence of CAD. However, genetic variants, which are only associated with higher HDL-C levels, do not decrease the frequency of myocardial infarction. This fact shows that HDL-C level is not a cause but a biomarker of CAD. Discoveries of rare variants in Mendelian disorders resulted in the successful development of drugs for the general population. An MRS may also predict the pharmacological effectiveness and adverse side effects of novel drugs targeting specific molecules. An MRS could become a standard process to be performed before the development of novel drugs. Furthermore, future guidelines for the prevention of CAD should consider the genetic information of individuals, which will result in precision medicine for cardiovascular diseases.
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Affiliation(s)
- Masa-Aki Kawashiri
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan.
| | - Hayato Tada
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Akihiro Nomura
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - Masakazu Yamagishi
- Department of Cardiovascular and Internal Medicine, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
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17
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Abstract
High-density lipoproteins (HDLs) have presented an attractive target for development of new therapies for cardiovascular prevention on the basis of epidemiology and preclinical studies demonstrating their protective properties. Development of HDL mimetics provides an opportunity to administer functional HDL. However, clinical trials have produced variable results, with no evidence to date that they reduce cardiovascular events. This article reviews development programs of HDL mimetics.
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Affiliation(s)
- Kohei Takata
- South Australian Health and Medical Research Institute, University of Adelaide, PO Box 11060, Adelaide, SA 5001, Australia
| | - Belinda A Di Bartolo
- South Australian Health and Medical Research Institute, University of Adelaide, PO Box 11060, Adelaide, SA 5001, Australia
| | - Stephen J Nicholls
- South Australian Health and Medical Research Institute, University of Adelaide, PO Box 11060, Adelaide, SA 5001, Australia.
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18
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Abstract
PURPOSE OF REVIEW Previous epidemiological studies and studies in experimental animals have provided strong evidence for the atheroprotective effect of HDL and its major apoprotein, apolipoprotein A-I (apoA-I). Identification of genetic loci associating apoA-I/HDL with cardiovascular disease is needed to establish a causal relationship. RECENT FINDINGS Pharmacological interventions to increase apoA-I or HDL cholesterol levels in humans are not associated with reduction in atherosclerosis. Genome wide association study (GWAS) studies in humans and hybrid mouse diversity panel (HMDP) studies looking for genetic variants associated with apoA-I or HDL cholesterol levels with cardiovascular disease and atherosclerosis have not provided strong evidence for their atheroprotective function. SUMMARY These findings indicate that GWAS and HMDP studies identifying possible genetic determinants of HDL and apoA-I function are needed.
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19
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Abstract
High-density lipoprotein cholesterol (HDL-C) levels are inversely related to risk of atherosclerotic cardiovascular disease (ASCVD). However, the simplistic assumption that HDL-C levels directly and causally impact atherogenesis has been challenged in recent years. The purpose of this article is to review the current state of knowledge regarding genetically determined HDL-C levels and ASCVD risk and determine what insight these studies provide into the causal relationship between HDL and atherosclerosis.
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Affiliation(s)
- Liam R Brunham
- Department of Medicine, University of British Columbia, Vancouver, Canada. .,Centre for Heart Lung Innovation, Providence Health Care Research Institute, University of British Columbia, St. Paul's Hospital, Room 166-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada. .,Translational Laboratory in Genetic Medicine (TLGM), Agency for Science, Technology and Research (A*STAR), Singapore, Singapore.
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20
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Smolders L, Plat J, Mensink RP. Dietary Strategies and Novel Pharmaceutical Approaches Targeting Serum ApoA-I Metabolism: A Systematic Overview. J Nutr Metab 2017; 2017:5415921. [PMID: 28695008 PMCID: PMC5485365 DOI: 10.1155/2017/5415921] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2017] [Accepted: 04/16/2017] [Indexed: 12/19/2022] Open
Abstract
The incidence of CHD is still increasing, which underscores the need for new preventive and therapeutic approaches to decrease CHD risk. In this respect, increasing apoA-I concentrations may be a promising approach, especially through increasing apoA-I synthesis. This review first provides insight into current knowledge on apoA-I production, clearance, and degradation, followed by a systematic review of dietary and novel pharmacological approaches to target apoA-I metabolism. For this, a systematic search was performed to identify randomized controlled intervention studies that examined effects of whole foods and (non)nutrients on apoA-I metabolism. In addition, novel pharmacological approaches were searched for, which were specifically developed to target apoA-I metabolism. We conclude that both dietary components and pharmacological approaches can be used to increase apoA-I concentrations or functionality. For the dietary components in particular, more knowledge about the underlying mechanisms is necessary, as increasing apoA-I per se does not necessarily translate into a reduced CHD risk.
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Affiliation(s)
- Lotte Smolders
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Jogchum Plat
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
| | - Ronald P. Mensink
- Department of Human Biology and Movement Sciences, School of Nutrition and Translational Research in Metabolism (NUTRIM), Maastricht University Medical Center, P.O. Box 616, 6200 MD Maastricht, Netherlands
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21
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Kataoka Y, Andrews J, Duong M, Nguyen T, Schwarz N, Fendler J, Puri R, Butters J, Keyserling C, Paolini JF, Dasseux JL, Nicholls SJ. Regression of coronary atherosclerosis with infusions of the high-density lipoprotein mimetic CER-001 in patients with more extensive plaque burden. Cardiovasc Diagn Ther 2017; 7:252-263. [PMID: 28567351 DOI: 10.21037/cdt.2017.02.01] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND CER-001 is an engineered pre-beta high-density lipoprotein (HDL) mimetic, which rapidly mobilizes cholesterol. Infusion of CER-001 3 mg/kg exhibited a potentially favorable effect on plaque burden in the CHI-SQUARE (Can HDL Infusions Significantly Quicken Atherosclerosis Regression) study. Since baseline atheroma burden has been shown as a determinant for the efficacy of HDL infusions, the degree of baseline atheroma burden might influence the effect of CER-001. METHODS CHI-SQUARE compared the effect of 6 weekly infusions of CER-001 (3, 6 and 12 mg/kg) vs. placebo on coronary atherosclerosis in 369 patients with acute coronary syndrome (ACS) using serial intravascular ultrasound (IVUS). Baseline percent atheroma volume (B-PAV) cutoff associated with atheroma regression following CER-001 infusions was determined by receiver-operating characteristics curve analysis. 369 subjects were stratified according to the cutoff. The effect of CER-001 at different doses was compared to placebo in each group. RESULTS A B-PAV ≥30% was the optimal cutoff associated with PAV regression following CER-001 infusions. CER-001 induced PAV regression in patients with B-PAV ≥30% but not in those with B-PAV <30% (-0.45%±2.65% vs. +0.34%±1.69%, P=0.01). Compared to placebo, the greatest PAV regression was observed with CER-001 3mg/kg in patients with B-PAV ≥30% (-0.96%±0.34% vs. -0.25%±0.31%, P=0.01), whereas there were no differences between placebo (+0.09%±0.36%) versus CER-001 in patients with B-PAV <30% (3 mg/kg; +0.41%±0.32%, P=0.39; 6 mg/kg; +0.27%±0.36%, P=0.76; 12 mg/kg; +0.32%±0.37%, P=0.97). CONCLUSIONS Infusions of CER-001 3 mg/kg induced the greatest atheroma regression in ACS patients with higher B-PAV. These findings identify ACS patients with more extensive disease as most likely to benefit from HDL mimetic therapy.
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Affiliation(s)
- Yu Kataoka
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Jordan Andrews
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - MyNgan Duong
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Tracy Nguyen
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Nisha Schwarz
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Jessica Fendler
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Rishi Puri
- Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA
| | - Julie Butters
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
| | | | | | | | - Stephen J Nicholls
- South Australian Health & Medical Research Institute, University of Adelaide, Adelaide, Australia
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22
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Pownall HJ, Rosales C, Gillard BK, Ferrari M. Native and Reconstituted Plasma Lipoproteins in Nanomedicine: Physicochemical Determinants of Nanoparticle Structure, Stability, and Metabolism. Methodist Debakey Cardiovasc J 2017; 12:146-150. [PMID: 27826368 DOI: 10.14797/mdcj-12-3-146] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Although many acute and chronic diseases are managed via pharmacological means, challenges remain regarding appropriate drug targeting and maintenance of therapeutic levels within target tissues. Advances in nanotechnology will overcome these challenges through the development of lipidic particles, including liposomes, lipoproteins, and reconstituted high-density lipoproteins (rHDL) that are potential carriers of water-soluble, hydrophobic, and amphiphilic molecules. Herein we summarize the properties of human plasma lipoproteins and rHDL, identify the physicochemical determinants of lipid transfer between phospholipid surfaces, and discuss strategies for increasing the plasma half-life of lipoprotein- and liposome-associated molecules.
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Affiliation(s)
- Henry J Pownall
- Houston Methodist Hospital, Houston, Texas; Weill-Cornell Medical College, New York, New York
| | - Corina Rosales
- Houston Methodist Hospital, Houston, Texas; Weill-Cornell Medical College, New York, New York
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23
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Di Bartolo BA, Schwarz N, Andrews J, Nicholls SJ. Infusional high-density lipoproteins therapies as a novel strategy for treating atherosclerosis. Arch Med Sci 2017; 13:210-214. [PMID: 28144273 PMCID: PMC5206363 DOI: 10.5114/aoms.2016.60941] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Accepted: 11/18/2015] [Indexed: 01/18/2023] Open
Abstract
High-density lipoproteins (HDL) have received considerable interest as a target for the development of novel anti-atherosclerotic agents beyond conventional approaches to lipid lowering. While a number of approaches have focused on modifying remodeling and expression pathways implicated in the regulation of HDL levels, an additional approach involves simply infusions of delipidated HDL. Several groups have advanced HDL infusions to clinical development with intriguing signs suggesting potentially favorable impacts at the level of the artery wall. The findings of early studies of infusional HDL therapies will be reviewed.
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Affiliation(s)
- Belinda A Di Bartolo
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Nisha Schwarz
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Jordan Andrews
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Stephen J Nicholls
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
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24
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Andrews J, Janssan A, Nguyen T, Pisaniello AD, Scherer DJ, Kastelein JJP, Merkely B, Nissen SE, Ray K, Schwartz GG, Worthley SG, Keyserling C, Dasseux JL, Butters J, Girardi J, Miller R, Nicholls SJ. Effect of serial infusions of reconstituted high-density lipoprotein (CER-001) on coronary atherosclerosis: rationale and design of the CARAT study. Cardiovasc Diagn Ther 2017; 7:45-51. [PMID: 28164012 DOI: 10.21037/cdt.2017.01.01] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND High-density lipoprotein (HDL) is believed to have atheroprotective properties, but an effective HDL-based therapy remains elusive. Early studies have suggested that infusion of reconstituted HDL promotes reverse cholesterol transport and vascular reactivity. The CER-001 Atherosclerosis Regression Acute Coronary Syndrome Trial (CARAT) is investigating the impact of infusing an engineered pre-beta HDL mimetic containing sphingomyelin (SM) and dipalmitoyl phosphatidlyglycerol (CER-001) on coronary atheroma volume in patients with a recent acute coronary syndrome (ACS). METHODS The CARAT is a phase 2, multicenter trial in which 292 patients with an ACS undergoing intracoronary ultrasonography and showing percent atheroma volume (PAV) greater than 30% are randomly assigned to treatment with ten infusions of CER-001 3 mg/kg or matching placebo, administered at weekly intervals. Intracoronary ultrasonography is repeated at the end of the treatment period. RESULTS The primary endpoint is the nominal change in PAV. Safety and tolerability will also be evaluated. CONCLUSIONS CARAT will establish whether serial 3 mg/kg infusions of an engineered pre-beta HDL mimetic containing SM and dipalmitoyl phosphatidlyglycerol (CER-001) will regress atherosclerotic plaque in patients with a recent ACS.
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Affiliation(s)
- Jordan Andrews
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Alex Janssan
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Tracy Nguyen
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Anthony D Pisaniello
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Daniel J Scherer
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - John J P Kastelein
- Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Bela Merkely
- Heart and Vascular Center, Semmelweis University, Budapest, Hungary
| | | | - Kausik Ray
- School of Public Health, Imperial College London, London, UK
| | | | - Stephen G Worthley
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | | | | | - Julie Butters
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Jacinta Girardi
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Rosemary Miller
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
| | - Stephen J Nicholls
- South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia
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Wacker BK, Dronadula N, Zhang J, Dichek DA. Local Vascular Gene Therapy With Apolipoprotein A-I to Promote Regression of Atherosclerosis. Arterioscler Thromb Vasc Biol 2016; 37:316-327. [PMID: 27932352 DOI: 10.1161/atvbaha.116.308258] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 11/28/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Gene therapy, delivered directly to the blood vessel wall, could potentially prevent atherosclerotic lesion growth and promote atherosclerosis regression. Previously, we reported that a helper-dependent adenoviral (HDAd) vector expressing apolipoprotein A-I (apoA-I) in carotid endothelium of fat-fed rabbits reduced early (4 weeks) atherosclerotic lesion growth. Here, we tested whether the same HDAd-delivered to the existing carotid atherosclerotic lesions-could promote regression. APPROACH AND RESULTS Rabbits (n=26) were fed a high-fat diet for 7 months, then treated with bilateral carotid gene transfer. One carotid was infused with an HDAd expressing apoA-I (HDAdApoAI) and the other with a control nonexpressing HDAd (HDAdNull). The side with HDAdApoAI was randomized. Rabbits were then switched to regular chow, lowering their plasma cholesterols by over 70%. ApoA-I mRNA and protein were detected in HDAdApoAI-transduced arteries. After 7 weeks of gene therapy, compared with HDAdNull-treated arteries in the same rabbits, HDAdApoAI-treated arteries had significantly less vascular cell adhesion molecule-1 expression (28%; P=0.04) along with modest but statistically insignificant trends toward decreased intimal lesion volume, lipid and macrophage content, and intercellular adhesion molecule-1 expression (9%-21%; P=0.1-0.4). Post hoc subgroup analysis of rabbits with small-to-moderate-sized lesions (n=20) showed that HDAdApoAI caused large reductions in lesion volume, lipid content, intercellular adhesion molecule-1, and vascular cell adhesion molecule-1 expression (30%-50%; P≤0.04 for all). Macrophage content was reduced by 30% (P=0.06). There was a significant interaction (P=0.02) between lesion size and treatment efficacy. CONCLUSIONS Even when administered on a background of aggressive lowering of plasma cholesterol, local HDAdApoAI vascular gene therapy may promote rapid regression of small-to-moderate-sized atherosclerotic lesions.
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Affiliation(s)
- Bradley K Wacker
- From the Department of Medicine, University of Washington School of Medicine, Seattle
| | - Nagadhara Dronadula
- From the Department of Medicine, University of Washington School of Medicine, Seattle
| | - Jingwan Zhang
- From the Department of Medicine, University of Washington School of Medicine, Seattle
| | - David A Dichek
- From the Department of Medicine, University of Washington School of Medicine, Seattle.
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Takata K, Imaizumi S, Zhang B, Miura SI, Saku K. Stabilization of high-risk plaques. Cardiovasc Diagn Ther 2016; 6:304-21. [PMID: 27500090 DOI: 10.21037/cdt.2015.10.03] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
The prevalence of atherosclerotic cardiovascular diseases (ASCVDs) is increasing globally and they have become the leading cause of death in most countries. Numerous experimental and clinical studies have been conducted to identify major risk factors and effective control strategies for ASCVDs. The development of imaging modalities with the ability to determine the plaque composition enables us to further identify high-risk plaque and evaluate the effectiveness of different treatment strategies. While intensive lipid-lowering by statins can stabilize or even regress plaque by various mechanisms, such as the reduction of lipid accumulation in a necrotic lipid core, the reduction of inflammation, and improvement of endothelial function, there are still considerable residual risks that need to be understood. We reviewed important findings regarding plaque vulnerability and some encouraging emerging approaches for plaque stabilization.
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Affiliation(s)
- Kohei Takata
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Satoshi Imaizumi
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Bo Zhang
- Department of Biochemistry, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
| | - Keijiro Saku
- Department of Cardiology, Fukuoka University School of Medicine, Fukuoka 814-0180, Japan
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27
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Andrews J, Puri R, Kataoka Y, Nicholls SJ, Psaltis PJ. Therapeutic modulation of the natural history of coronary atherosclerosis: lessons learned from serial imaging studies. Cardiovasc Diagn Ther 2016; 6:282-303. [PMID: 27500089 DOI: 10.21037/cdt.2015.10.02] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Despite advances in risk prediction, preventive and therapeutic strategies, atherosclerotic cardiovascular disease remains a major public health challenge worldwide, carrying considerable morbidity, mortality and health economic burden. There continues to be a need to better understand the natural history of this disease to guide the development of more effective treatment, integral to which is the rapidly evolving field of coronary artery imaging. Various imaging modalities have been refined to enable detailed visualization of the pathological substrate of atherosclerosis, providing accurate and reproducible measures of coronary plaque burden and composition, including the presence of high-risk characteristics. The serial application of such techniques, including coronary computed tomography angiography (CTA), intravascular ultrasound (IVUS) and optical coherence tomography (OCT) have uncovered important insights into the progression of coronary plaque over time in patients with stable and unstable coronary artery disease (CAD), and its responsiveness to therapeutic interventions. Here we review the use of different imaging modalities for the surveillance of coronary atherosclerosis and the lessons they have provided about the modulation of CAD by both traditional and experimental therapies.
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Affiliation(s)
- Jordan Andrews
- Vascular Research Centre, Heart Health Theme, South Australian Health and Medical Research Institute & School of Medicine, University of Adelaide, Adelaide, Australia
| | - Rishi Puri
- Québec Heart & Lung Institute (IUCPQ), Hospital Laval, Québec (Québec), Canada; ; Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland, Ohio, USA
| | - Yu Kataoka
- National Cerebral and Cardiovascular Center, Osaka, Japan
| | - Stephen J Nicholls
- Vascular Research Centre, Heart Health Theme, South Australian Health and Medical Research Institute & School of Medicine, University of Adelaide, Adelaide, Australia
| | - Peter J Psaltis
- Vascular Research Centre, Heart Health Theme, South Australian Health and Medical Research Institute & School of Medicine, University of Adelaide, Adelaide, Australia
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28
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Westerterp M, Tsuchiya K, Tattersall IW, Fotakis P, Bochem AE, Molusky MM, Ntonga V, Abramowicz S, Parks JS, Welch CL, Kitajewski J, Accili D, Tall AR. Deficiency of ATP-Binding Cassette Transporters A1 and G1 in Endothelial Cells Accelerates Atherosclerosis in Mice. Arterioscler Thromb Vasc Biol 2016; 36:1328-37. [PMID: 27199450 DOI: 10.1161/atvbaha.115.306670] [Citation(s) in RCA: 78] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 05/10/2016] [Indexed: 02/02/2023]
Abstract
OBJECTIVE Plasma high-density lipoproteins have several putative antiatherogenic effects, including preservation of endothelial functions. This is thought to be mediated, in part, by the ability of high-density lipoproteins to promote cholesterol efflux from endothelial cells (ECs). The ATP-binding cassette transporters A1 and G1 (ABCA1 and ABCG1) interact with high-density lipoproteins to promote cholesterol efflux from ECs. To determine the impact of endothelial cholesterol efflux pathways on atherogenesis, we prepared mice with endothelium-specific knockout of Abca1 and Abcg1. APPROACH AND RESULTS Generation of mice with EC-ABCA1 and ABCG1 deficiency required crossbreeding Abca1(fl/fl)Abcg1(fl/fl)Ldlr(-/-) mice with the Tie2Cre strain, followed by irradiation and transplantation of Abca1(fl/fl)Abcg1(fl/fl) bone marrow to abrogate the effects of macrophage ABCA1 and ABCG1 deficiency induced by Tie2Cre. After 20 to 22 weeks of Western-type diet, both single EC-Abca1 and Abcg1 deficiency increased atherosclerosis in the aortic root and whole aorta. Combined EC-Abca1/g1 deficiency caused a significant further increase in lesion area at both sites. EC-Abca1/g1 deficiency dramatically enhanced macrophage lipid accumulation in the branches of the aorta that are exposed to disturbed blood flow, decreased aortic endothelial NO synthase activity, and increased monocyte infiltration into the atherosclerotic plaque. Abca1/g1 deficiency enhanced lipopolysaccharide-induced inflammatory gene expression in mouse aortic ECs, which was recapitulated by ABCG1 deficiency in human aortic ECs. CONCLUSIONS These studies provide direct evidence that endothelial cholesterol efflux pathways mediated by ABCA1 and ABCG1 are nonredundant and atheroprotective, reflecting preservation of endothelial NO synthase activity and suppression of endothelial inflammation, especially in regions of disturbed arterial blood flow.
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MESH Headings
- ATP Binding Cassette Transporter 1/deficiency
- ATP Binding Cassette Transporter 1/genetics
- ATP Binding Cassette Transporter, Subfamily G, Member 1/deficiency
- ATP Binding Cassette Transporter, Subfamily G, Member 1/genetics
- Animals
- Aorta, Thoracic/metabolism
- Aorta, Thoracic/pathology
- Aorta, Thoracic/physiopathology
- Aortic Diseases/genetics
- Aortic Diseases/metabolism
- Aortic Diseases/pathology
- Atherosclerosis/genetics
- Atherosclerosis/metabolism
- Atherosclerosis/pathology
- Atherosclerosis/physiopathology
- Bone Marrow Transplantation
- Cholesterol/metabolism
- Diet, High-Fat
- Disease Models, Animal
- Disease Progression
- Endothelial Cells/metabolism
- Endothelial Cells/pathology
- Genetic Predisposition to Disease
- Inflammation Mediators/metabolism
- Macrophages/metabolism
- Male
- Mice, Knockout
- Monocytes/metabolism
- Neovascularization, Physiologic
- Nitric Oxide Synthase Type III/metabolism
- Phenotype
- Plaque, Atherosclerotic
- Receptors, LDL/deficiency
- Receptors, LDL/genetics
- Regional Blood Flow
- Retinal Neovascularization/genetics
- Retinal Neovascularization/metabolism
- Time Factors
- Tissue Culture Techniques
- Whole-Body Irradiation
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Affiliation(s)
- Marit Westerterp
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.).
| | - Kyoichiro Tsuchiya
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Ian W Tattersall
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Panagiotis Fotakis
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Andrea E Bochem
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Matthew M Molusky
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Vusisizwe Ntonga
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Sandra Abramowicz
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - John S Parks
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Carrie L Welch
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Jan Kitajewski
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Domenico Accili
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
| | - Alan R Tall
- From the Division of Molecular Medicine, Department of Medicine (M.W., P.F., A.E.B., M.M.M., V.N., S.A., C.L.W., A.R.T.), Naomi Berrie Diabetes Center (K.T., D.A.), and Department of Pathology, Obstetrics, and Gynaecology (I.W.T., J.K.), Columbia University, New York, NY; Section on Molecular Genetics, Department of Pediatrics, University Medical Center Groningen, Groningen, The Netherlands (M.W.); Department of Diabetes, Endocrinology, and Metabolism, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan (K.T.); and Section on Molecular Medicine, Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC (J.S.P.)
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Abstract
Several recent reports have raised doubts about the atheroprotective role of high-density lipoprotein cholesterol (HDL-C). Nevertheless, a substantial body of work supports the validity of pharmacological interventions able to enhance HDL function, as opposed to raising HDL-C levels per se. In this article, we briefly review the development of pharmacological interventions that target apoA-I and HDL function as a means of reducing atherosclerotic risk: small molecule pharmaceuticals, small HDL mimetic peptides, and infusion of apoA-I-containing particles.
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Castle J, Feinstein SB. Drug and Gene Delivery using Sonoporation for Cardiovascular Disease. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2016; 880:331-8. [DOI: 10.1007/978-3-319-22536-4_18] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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Murray SC, Gillard BK, Ludtke SJ, Pownall HJ. Direct Measurement of the Structure of Reconstituted High-Density Lipoproteins by Cryo-EM. Biophys J 2015; 110:810-6. [PMID: 26743047 DOI: 10.1016/j.bpj.2015.10.028] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2015] [Revised: 10/15/2015] [Accepted: 10/20/2015] [Indexed: 12/22/2022] Open
Abstract
Early forms of high-density lipoproteins (HDL), nascent HDL, are formed by the interaction of apolipoprotein AI with macrophage and hepatic ATP-binding cassette transporter member 1. Various plasma activities convert nascent to mature HDL, comprising phosphatidylcholine (PC) and cholesterol, which are selectively removed by hepatic receptors. This process is important in reducing the cholesterol burden of arterial wall macrophages, an important cell type in all stages of atherosclerosis. Interaction of apolipoprotein AI with dimyristoyl (DM)PC forms reconstituted (r)HDL, which is a good model of nascent HDL. rHDL have been used as an antiathersclerosis therapy that enhances reverse cholesterol transport in humans and animal models. Thus, identification of the structure of rHDL would inform about that of nascent HDL and how rHDL improves reverse cholesterol transport in an atheroprotective way. Early studies of rHDL suggested a discoidal structure, which included pairs of antiparallel helices of apolipoprotein AI circumscribing a phospholipid bilayer. Another rHDL model based on small angle neutron scattering supported a double superhelical structure. Herein, we report a cryo-electron microscopy-based model of a large rHDL formed spontaneously from apolipoprotein AI, cholesterol, and excess DMPC and isolated to near homogeneity. After reconstruction we obtained an rHDL structure comprising DMPC, cholesterol, and apolipoprotein AI (423:74:1 mol/mol) forming a discoidal particle 360 Å in diameter and 45 Å thick; these dimensions are consistent with the stoichiometry of the particles. Given that cryo-electron microscopy directly observes projections of individual rHDL particles in different orientations, we can unambiguously state that rHDL particles are protein bounded discoidal bilayers.
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Affiliation(s)
| | | | | | - Henry J Pownall
- Houston Methodist Research Institute, Houston, Texas; Weill Cornell Medicine, Houston, Texas.
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32
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Abstract
PURPOSE OF REVIEW Increasing interest has focused on the strategies that target the atheroprotective properties of HDL in order to reduce cardiovascular risk. The potential impact of strategies to acutely promote HDL functionality will be reviewed. RECENT FINDINGS Population and animal studies suggest that HDLs have a protective impact on atherosclerotic plaque. However, the failure of recent clinical trials of HDL cholesterol-raising agents has raised concerns that this may not be a viable strategy to reduce cardiovascular risk. Increasing attention has highlighted the importance of the functional quality, as opposed to quantity, of HDL with evidence of impaired HDL function in the setting of acute coronary syndromes (ACSs). The finding that infusing HDL in patients with recent acute ischemic events promotes the rapid regression of coronary atherosclerosis suggests a potentially useful strategy for ACS patients, although this remains to be fully established in large clinical outcome trials. SUMMARY Infusing HDL has favorable effects on coronary atherosclerosis in ACS patients, suggesting a potentially beneficial therapeutic strategy to acutely promote HDL functionality.
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Affiliation(s)
- MyNgan Duong
- aSouth Australian Health and Medical Research InstitutebDepartment of Medicine, University of Adelaide, Adelaide, South Australia, Australia
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33
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Kühnast S, Fiocco M, van der Hoorn JWA, Princen HMG, Jukema JW. Innovative pharmaceutical interventions in cardiovascular disease: Focusing on the contribution of non-HDL-C/LDL-C-lowering versus HDL-C-raising: A systematic review and meta-analysis of relevant preclinical studies and clinical trials. Eur J Pharmacol 2015; 763:48-63. [PMID: 25989133 DOI: 10.1016/j.ejphar.2015.03.089] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 01/27/2015] [Accepted: 03/05/2015] [Indexed: 12/25/2022]
Abstract
Non-HDL-cholesterol is well recognised as a primary causal risk factor in cardiovascular disease. However, despite consistent epidemiological evidence for an inverse association between HDL-C and coronary heart disease, clinical trials aimed at raising HDL-C (AIM-HIGH, HPS2-THRIVE, dal-OUTCOMES) failed to meet their primary goals. This systematic review and meta-analysis investigated the effects of established and novel treatment strategies, specifically targeting HDL, on inhibition of atherosclerosis in cholesteryl ester transfer protein-expressing animals, and the prevention of clinical events in randomised controlled trials. Linear regression analyses using data from preclinical studies revealed associations for TC and non-HDL-C and lesion area (R(2)=0.258, P=0.045; R(2)=0.760, P<0.001), but not for HDL-C (R(2)=0.030, P=0.556). In clinical trials, non-fatal myocardial infarction risk was significantly less in the treatment group with pooled odd ratios of 0.87 [0.81; 0.94] for all trials and 0.85 [0.78; 0.93] after excluding some trials due to off-target adverse events, whereas all-cause mortality was not affected (OR 1.05 [0.99-1.10]). Meta-regression analyses revealed a trend towards an association between between-group differences in absolute change from baseline in LDL-C and non-fatal myocardial infarction (P=0.066), whereas no correlation was found for HDL-C (P=0.955). We conclude that the protective role of lowering LDL-C and non-HDL-C is well-established. The contribution of raising HDL-C on inhibition of atherosclerosis and the prevention of cardiovascular disease remains undefined and may be dependent on the mode of action of HDL-C-modification. Nonetheless, treatment strategies aimed at improving HDL function and raising apolipoprotein A-I may be worth exploring.
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Affiliation(s)
- Susan Kühnast
- TNO-Metabolic Health Research, Gaubius Laboratory, Leiden, The Netherlands; Department of Cardiology, LUMC, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, The Netherlands
| | - Marta Fiocco
- Department of Medical Statistics and Bioinformatics, LUMC, Leiden, The Netherlands; Mathematical Institute, Leiden University, Leiden, The Netherlands
| | - José W A van der Hoorn
- TNO-Metabolic Health Research, Gaubius Laboratory, Leiden, The Netherlands; Department of Cardiology, LUMC, Leiden, The Netherlands; Einthoven Laboratory for Experimental Vascular Medicine, LUMC, Leiden, The Netherlands
| | - Hans M G Princen
- TNO-Metabolic Health Research, Gaubius Laboratory, Leiden, The Netherlands.
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Comparison of Plaque Burden and Vessel Remodeling in Obstructive Saphenous Vein Graft Lesions as Assessed by Intravascular Ultrasound and Dual-source Computed Tomography. J Thorac Imaging 2015; 31:49-55. [PMID: 25974744 DOI: 10.1097/rti.0000000000000158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The aim of our study was to compare plaque burden and vessel remodeling of obstructive saphenous vein graft (SVG) lesions as assessed by dual-source computed tomography (DSCT) and intravascular ultrasound (IVUS). MATERIALS AND METHODS Preintervention DSCT examination and IVUS were performed in consecutive patients before percutaneous treatment of the SVG lesion. SVG vessel and lumen areas were measured with use of DSCT and IVUS at the minimal lumen area (MLA) site and at proximal and distal reference sites. Plaque burden was defined as the ratio of plaque and vessel area. Remodeling index was defined as the ratio of the SVG area at the MLA site to the mean reference SVG area. RESULTS Twenty-four obstructive SVG lesions were imaged with DSCT and IVUS before stent implantation in 24 patients. The SVG cross-sectional area at the MLA site measured by IVUS and DSCT was similar (17.0±4.5 vs. 17.3±5.3 mm, P=0.6) and well correlated (R=0.77, P<0.001). Similarly, plaque burden and remodeling index assessments did not differ significantly between the 2 imaging modalities (79.0%±4.0% vs. 81.0%±8.0%, P=0.18, and 1.09±0.22 vs. 1.07±0.32, P=0.7 for IVUS vs. DSCT for plaque burden and remodeling, respectively). The correlation between IVUS-assessed and DSCT-assessed plaque burden and remodeling index was moderate to good (R=0.55, P=0.01 and R=0.77, P<0.001, respectively, for plaque burden and remodeling index). CONCLUSIONS There is moderate to good correlation between DSCT and IVUS in the assessment of vessel remodeling and plaque burden in obstructive SVG lesions. Noninvasive assessment and monitoring of SVG disease is feasible using DSCT.
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Castle JW, Kent KP, Fan Y, Wallace KD, Davis CEL, Roberts JC, Marino ME, Thomenius KE, Lim HW, Coles E, Davidson MH, Feinstein SB, DeMaria A. Therapeutic ultrasound: Increased HDL-Cholesterol following infusions of acoustic microspheres and apolipoprotein A-I plasmids. Atherosclerosis 2015; 241:92-9. [PMID: 25969892 DOI: 10.1016/j.atherosclerosis.2015.04.817] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/24/2015] [Accepted: 04/29/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Low levels of HDL-C are an independent cardiovascular risk factor associated with increased premature cardiovascular death. However, HDL-C therapies historically have been limited by issues relating to immunogenicity, hepatotoxicity and scalability, and have been ineffective in clinical trials. OBJECTIVE We examined the feasibility of using injectable acoustic microspheres to locally deliver human ApoA-I DNA plasmids in a pre-clinical model and quantify increased production of HDL-C in vivo. METHODS Our novel site-specific gene delivery system was examined in naïve rat model and comprised the following steps: (1) intravenous co-administration of a solution containing acoustically active microspheres (Optison™, GE Healthcare, Princeton, New Jersey) and human ApoA-I plasmids; (2) ultrasound verification of the presence of the microspheres within the liver vasculature; (3) External application of locally-directed acoustic energy, (4) induction of microsphere disruption and in situ sonoporation; (4) ApoA-I plasmid hepatic uptake; (5) transcription and expression of human ApoA-I protein; and (6) elevation of serum HDL-C. RESULTS Co-administration of ApoA-I plasmids and acoustic microspheres, activated by external ultrasound energy, resulted in transcription and production of human ApoA-I protein and elevated serum HDL-C in rats (up to 61%; p-value < 0.05). CONCLUSIONS HDL-C was increased in rats following ultrasound directed delivery of human ApoA-I plasmids by microsphere sonoporation. The present method provides a novel approach to promote ApoA-I synthesis and nascent HDL-C elevation, potentially permitting the use of a minimally-invasive ultrasound-based, gene delivery system for treating individuals with low HDL-C.
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Affiliation(s)
| | | | - Ying Fan
- General Electric Global Research, Niskayuna, NY, USA
| | | | | | | | | | | | - Hae W Lim
- Formerly GE Global Research, Niskayuna, NY, USA
| | | | - Michael H Davidson
- SonoGene LLC, Glen Ellyn, IL, USA; University of Chicago, Pritzker School of Medicine, Chicago, IL, USA
| | - Steven B Feinstein
- SonoGene LLC, Glen Ellyn, IL, USA; Rush University Medical Center, Chicago, IL, USA
| | - Anthony DeMaria
- Sulpizio Cardiovascular Center, University of California, San Diego, CA, USA
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Brunham LR, Hayden MR. Human genetics of HDL: Insight into particle metabolism and function. Prog Lipid Res 2015; 58:14-25. [DOI: 10.1016/j.plipres.2015.01.001] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2014] [Revised: 12/22/2014] [Accepted: 01/07/2015] [Indexed: 10/24/2022]
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Pownall HJ, Rosales C, Gillard BK, Gotto AM. High-Density Lipoprotein Therapies-Then and Now. Atherosclerosis 2015. [DOI: 10.1002/9781118828533.ch42] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Du XM, Kim MJ, Hou L, Le Goff W, Chapman MJ, Van Eck M, Curtiss LK, Burnett JR, Cartland SP, Quinn CM, Kockx M, Kontush A, Rye KA, Kritharides L, Jessup W. HDL particle size is a critical determinant of ABCA1-mediated macrophage cellular cholesterol export. Circ Res 2015; 116:1133-42. [PMID: 25589556 DOI: 10.1161/circresaha.116.305485] [Citation(s) in RCA: 224] [Impact Index Per Article: 24.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
RATIONALE High-density lipoprotein (HDL) is a heterogeneous population of particles. Differences in the capacities of HDL subfractions to remove cellular cholesterol may explain variable correlations between HDL-cholesterol and cardiovascular risk and inform future targets for HDL-related therapies. The ATP binding cassette transporter A1 (ABCA1) facilitates cholesterol efflux to lipid-free apolipoprotein A-I, but the majority of apolipoprotein A-I in the circulation is transported in a lipidated state and ABCA1-dependent efflux to individual HDL subfractions has not been systematically studied. OBJECTIVE Our aims were to determine which HDL particle subfractions are most efficient in mediating cellular cholesterol efflux from foam cell macrophages and to identify the cellular cholesterol transporters involved in this process. METHODS AND RESULTS We used reconstituted HDL particles of defined size and composition, isolated subfractions of human plasma HDL, cell lines stably expressing ABCA1 or ABCG1, and both mouse and human macrophages in which ABCA1 or ABCG1 expression was deleted. We show that ABCA1 is the major mediator of macrophage cholesterol efflux to HDL, demonstrating most marked efficiency with small, dense HDL subfractions (HDL3b and HDL3c). ABCG1 has a lesser role in cholesterol efflux and a negligible role in efflux to HDL3b and HDL3c subfractions. CONCLUSIONS Small, dense HDL subfractions are the most efficient mediators of cholesterol efflux, and ABCA1 mediates cholesterol efflux to small dense HDL and to lipid-free apolipoprotein A-I. HDL-directed therapies should target increasing the concentrations or the cholesterol efflux capacity of small, dense HDL species in vivo.
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Affiliation(s)
- Xian-Ming Du
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Mi-Jurng Kim
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Liming Hou
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Wilfried Le Goff
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - M John Chapman
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Miranda Van Eck
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Linda K Curtiss
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - John R Burnett
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Sian P Cartland
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Carmel M Quinn
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Maaike Kockx
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Anatol Kontush
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Kerry-Anne Rye
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Leonard Kritharides
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.)
| | - Wendy Jessup
- From the Centre for Vascular Research, University of New South Wales, Sydney, New South Wales, Australia (X.-M.D., M.-J.K., L.H., S.P.C., C.M.Q., K.-A.R); INSERM, UMR_1166, Research Institute of Cardiovascular Disease, Metabolism and Nutrition, Pitié-Salpétrière University Hospital, Paris, France (W.L.G., M.J.C., A.K.); Université Pierre et Marie Curie-Paris 6, Paris, France (W.L.G., M.J.C., A.K.); Division of Biopharmaceutics, Leiden Academic Centre for Drug Research, Leiden, The Netherlands (M.V.E.); Department of Immunology and Microbial Science, The Scripps Research Institute, La Jolla, CA (L.K.C.); Department of Clinical Biochemistry, Royal Perth Hospital, Perth, Western Australia, Australia (J.R.B.); School of Medicine and Pharmacology, University of Western Australia, Crawley, Western Australia, Australia (J.R.B.); Atherosclerosis Laboratory, ANZAC Research Institute, University of Sydney, Sydney, New South Wales, Australia (M.K., L.K., W.J.); and Department of Cardiology, Concord Hospital, Sydney, New South Wales, Australia (L.K.).
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Abstract
A wealth of evidence indicates that plasma levels of high-density lipoprotein cholesterol (HDL-C) are inversely related to the risk of cardiovascular disease (CVD). Consequently, HDL-C has been considered a target for therapy in order to reduce the residual CVD burden that remains significant, even after application of current state-of-the-art medical interventions. In recent years, however, a number of clinical trials of therapeutic strategies that increase HDL-C levels failed to show the anticipated beneficial effect on CVD outcomes. As a result, attention has begun to shift toward strategies to improve HDL functionality, rather than levels of HDL-C per se. ApoA-I, the major protein component of HDL, is considered to play an important role in many of the antiatherogenic functions of HDL, most notably reverse cholesterol transport (RCT), and several therapies have been developed to mimic apoA-I function, including administration of apoA-I, mutated variants of apoA-I, and apoA-I mimetic peptides. Based on the potential anti-inflammatory effects, apoA-I mimetics hold promise not only as anti-atherosclerotic therapy but also in other therapeutic areas.
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Affiliation(s)
- R M Stoekenbroek
- Department of Vascular Medicine, Academic Medical Center, 22660, 1100 DD, Amsterdam, The Netherlands
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Santos-Gallego CG, Badimon JJ, Rosenson RS. Beginning to understand high-density lipoproteins. Endocrinol Metab Clin North Am 2014; 43:913-47. [PMID: 25432389 DOI: 10.1016/j.ecl.2014.08.001] [Citation(s) in RCA: 77] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
This article reconciles the classic view of high-density lipoproteins (HDL) associated with low risk for cardiovascular disease (CVD) with recent data (genetics studies and randomized clinical trials) casting doubt over the widely accepted beneficial role of HDL regarding CVD risk. Although HDL cholesterol has been used as a surrogate measure to investigate HDL function, the cholesterol content in HDL particles is not an indicator of the atheroprotective properties of HDL. Thus, more precise measures of HDL metabolism are needed to reflect and account for the beneficial effects of HDL particles. Current and emerging therapies targeting HDL are discussed.
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Affiliation(s)
- Carlos G Santos-Gallego
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1030, New York, NY 10029, USA
| | - Juan J Badimon
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1030, New York, NY 10029, USA
| | - Robert S Rosenson
- Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, One Gustave Levy Place, Box 1030, New York, NY 10029, USA.
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Uehara Y, Saku K. High-density lipoprotein and atherosclerosis: Roles of lipid transporters. World J Cardiol 2014; 6:1049-1059. [PMID: 25349649 PMCID: PMC4209431 DOI: 10.4330/wjc.v6.i10.1049] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2014] [Revised: 02/10/2014] [Accepted: 08/31/2014] [Indexed: 02/06/2023] Open
Abstract
Various previous studies have found a negative correlation between the risk of cardiovascular events and serum high-density lipoprotein (HDL) cholesterol levels. The reverse cholesterol transport, a pathway of cholesterol from peripheral tissue to liver which has several potent antiatherogenic properties. For instance, the particles of HDL mediate to transport cholesterol from cells in arterial tissues, particularly from atherosclerotic plaques, to the liver. Both ATP-binding cassette transporters (ABC) A1 and ABCG1 are membrane cholesterol transporters and have been implicated in mediating cholesterol effluxes from cells in the presence of HDL and apolipoprotein A-I, a major protein constituent of HDL. Previous studies demonstrated that ABCA1 and ABCG1 or the interaction between ABCA1 and ABCG1 exerted antiatherosclerotic effects. As a therapeutic approach for increasing HDL cholesterol levels, much focus has been placed on increasing HDL cholesterol levels as well as enhancing HDL biochemical functions. HDL therapies that use injections of reconstituted HDL, apoA-I mimetics, or full-length apoA-I have shown dramatic effectiveness. In particular, a novel apoA-I mimetic peptide, Fukuoka University ApoA-I Mimetic Peptide, effectively removes cholesterol via specific ABCA1 and other transporters, such as ABCG1, and has an antiatherosclerotic effect by enhancing the biological functions of HDL without changing circulating HDL cholesterol levels. Thus, HDL-targeting therapy has significant atheroprotective potential, as it uses lipid transporter-targeting agents, and may prove to be a therapeutic tool for atherosclerotic cardiovascular diseases.
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Kingwell BA, Chapman MJ, Kontush A, Miller NE. HDL-targeted therapies: progress, failures and future. Nat Rev Drug Discov 2014; 13:445-64. [DOI: 10.1038/nrd4279] [Citation(s) in RCA: 256] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Subedi BH, Joshi PH, Jones SR, Martin SS, Blaha MJ, Michos ED. Current guidelines for high-density lipoprotein cholesterol in therapy and future directions. Vasc Health Risk Manag 2014; 10:205-16. [PMID: 24748800 PMCID: PMC3986285 DOI: 10.2147/vhrm.s45648] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Many studies have suggested that a significant risk factor for atherosclerotic cardiovascular disease (ASCVD) is low high-density lipoprotein cholesterol (HDL-C). Therefore, increasing HDL-C with therapeutic agents has been considered an attractive strategy. In the prestatin era, fibrates and niacin monotherapy, which cause modest increases in HDL-C, reduced ASCVD events. Since their introduction, statins have become the cornerstone of lipoprotein therapy, the benefits of which are primarily attributed to decrease in low-density lipoprotein cholesterol. Findings from several randomized trials involving niacin or cholesteryl ester transfer protein inhibitors have challenged the concept that a quantitative elevation of plasma HDL-C will uniformly translate into ASCVD benefits. Consequently, the HDL, or more correctly, HDL-C hypothesis has become more controversial. There are no clear guidelines thus far for targeting HDL-C or HDL due to lack of solid outcomes data for HDL specific therapies. HDL-C levels are only one marker of HDL out of its several structural or functional properties. Novel approaches are ongoing in developing and assessing agents that closely mimic the structure of natural HDL or replicate its various functions, for example, reverse cholesterol transport, vasodilation, anti-inflammation, or inhibition of platelet aggregation. Potential new approaches like HDL infusions, delipidated HDL, liver X receptor agonists, Apo A-I upregulators, Apo A mimetics, and gene therapy are in early phase trials. This review will outline current therapies and describe future directions for HDL therapeutics.
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Affiliation(s)
- Bishnu H Subedi
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA ; Greater Baltimore Medical Center, Baltimore, MD, USA
| | - Parag H Joshi
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Steven R Jones
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Seth S Martin
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Michael J Blaha
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
| | - Erin D Michos
- Johns Hopkins Ciccarone Center for the Prevention of Heart Disease, Baltimore, MD, USA
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45
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van Capelleveen JC, Brewer HB, Kastelein JJP, Hovingh GK. Novel therapies focused on the high-density lipoprotein particle. Circ Res 2014; 114:193-204. [PMID: 24385512 DOI: 10.1161/circresaha.114.301804] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Cardiovascular disease (CVD) remains a major burden for morbidity and mortality in the general population, despite current efficacious low-density lipoprotein-cholesterol-lowering therapies. Consequently, novel therapies are required to reduce this residual risk. Prospective epidemiological studies have shown that high-density lipoprotein-cholesterol (HDL-C) levels are inversely correlated with cardiovascular disease risk, and this initiated the quest for HDL-C-increasing therapies. Consequently, several different targets in HDL metabolism have been identified. Initial studies addressing the effect of cholesteryl ester transfer protein inhibition on cardiovascular disease outcome have been discontinued for reasons of futility or increased mortality. As of yet, 2 cholesteryl ester transfer protein inhibitors are still in phase III studies. Other HDL-based interventions, such as apolipoprotein A1-based compounds, ABC-transporter upregulators, selective peroxisome proliferator-activated receptor modulators and lecithin-cholesterol acyltransferase-based therapy, hold great promise for the future. The aim of this review is to provide a comprehensive overview of HDL-targeted pharmaceutical strategies in humans, both in early development as well as in late stage clinical trials.
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Affiliation(s)
- Julian C van Capelleveen
- From the Department of Vascular Medicine, Academic Medical Center, Amsterdam, The Netherlands (J.C.v.C., J.J.P.K., G.K.H.); and MedStar Research Institute, Washington Hospital Center, Washington, DC (H.B.B.)
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46
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Nicholls SJ, Andrews J, Moon KW. Exploring the natural history of atherosclerosis with intravascular ultrasound. Expert Rev Cardiovasc Ther 2014; 5:295-306. [PMID: 17338673 DOI: 10.1586/14779072.5.2.295] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Intravascular ultrasound has emerged as the preferred imaging modality for the characterization of atherosclerotic plaque within the coronary arteries. Ultrasonic imaging reveals the presence of more extensive atheroma than suggested by conventional angiography in patients with coronary artery disease. The ability to precisely quantify atheroma volume in an arterial segment at different time points provides the unique opportunity to investigate the factors that influence the natural history of atheroma progression. Accordingly, serial intravascular ultrasound has been incorporated into a number of clinical trials that have evaluated the impact of medical therapies that modify established risk factors and novel pathological targets. This article will review the increasing role of imaging modalities in the assessment of atherosclerosis and factors that influence its natural history.
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Affiliation(s)
- Stephen J Nicholls
- Cleveland Clinic, Department of Cardiovascular Medicine, Mail Code JJ65, 9500 Euclid Ave, Cleveland OH, USA.
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47
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Hewing B, Parathath S, Barrett T, Chung WKK, Astudillo YM, Hamada T, Ramkhelawon B, Tallant TC, Yusufishaq MSS, Didonato JA, Huang Y, Buffa J, Berisha SZ, Smith JD, Hazen SL, Fisher EA. Effects of native and myeloperoxidase-modified apolipoprotein a-I on reverse cholesterol transport and atherosclerosis in mice. Arterioscler Thromb Vasc Biol 2014; 34:779-89. [PMID: 24407029 DOI: 10.1161/atvbaha.113.303044] [Citation(s) in RCA: 110] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Preclinical and clinical studies have shown beneficial effects of infusions of apolipoprotein A-I (ApoA-I) on atherosclerosis. ApoA-I is also a target for myeloperoxidase-mediated oxidation, leading in vitro to a loss of its ability to promote ATP-binding cassette transporter A1-dependent macrophage cholesterol efflux. Therefore, we hypothesized that myeloperoxidase-mediated ApoA-I oxidation would impair its promotion of reverse cholesterol transport in vivo and the beneficial effects on atherosclerotic plaques. APPROACH AND RESULTS ApoA-I(-/-) or apolipoprotein E-deficient mice were subcutaneously injected with native human ApoA-I, oxidized human ApoA-I (myeloperoxidase/hydrogen peroxide/chloride treated), or carrier. Although early postinjection (8 hours) levels of total ApoA-I in plasma were similar for native versus oxidized human ApoA-I, native ApoA-I primarily resided within the high-density lipoprotein fraction, whereas the majority of oxidized human ApoA-I was highly cross-linked and not high-density lipoprotein particle associated, consistent with impaired ATP-binding cassette transporter A1 interaction. In ApoA-I(-/-) mice, ApoA-I oxidation significantly impaired reverse cholesterol transport in vivo. In advanced aortic root atherosclerotic plaques of apolipoprotein E-deficient mice, native ApoA-I injections led to significant decreases in lipid content, macrophage number, and an increase in collagen content; in contrast, oxidized human ApoA-I failed to mediate these changes. The decrease in plaque macrophages with native ApoA-I was accompanied by significant induction of their chemokine receptor CCR7. Furthermore, only native ApoA-I injections led to a significant reduction of inflammatory M1 and increase in anti-inflammatory M2 macrophage markers in the plaques. CONCLUSIONS Myeloperoxidase-mediated oxidation renders ApoA-I dysfunctional and unable to (1) promote reverse cholesterol transport, (2) mediate beneficial changes in the composition of atherosclerotic plaques, and (3) pacify the inflammatory status of plaque macrophages.
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Affiliation(s)
- Bernd Hewing
- From the Department of Medicine, Division of Cardiology and the Marc and Ruti Bell Program in Vascular Biology, New York University School of Medicine (B.H., S.P., T.B., W.K.K.C., Y.M.A., T.H., B.R., E.A.F.); Medizinische Klinik für Kardiologie und Angiologie, Charité-Universitaetsmedizin Berlin, Berlin, Germany (B.H.); and Department of Cellular and Molecular Medicine, Cleveland Clinic Lerner Research Institute, OH (T.C.T., M.S.S.Y., J.A.D., Y.H., J.B., S.Z.B., J.D.S., S.L.H.)
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48
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Westerterp M, Bochem AE, Yvan-Charvet L, Murphy AJ, Wang N, Tall AR. ATP-Binding Cassette Transporters, Atherosclerosis, and Inflammation. Circ Res 2014; 114:157-70. [DOI: 10.1161/circresaha.114.300738] [Citation(s) in RCA: 184] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Affiliation(s)
- Marit Westerterp
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
| | - Andrea E. Bochem
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
| | - Laurent Yvan-Charvet
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
| | - Andrew J. Murphy
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
| | - Nan Wang
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
| | - Alan R. Tall
- From the Division of Molecular Medicine, Department of Medicine, Columbia University, New York, NY (M.W., A.E.B., L.Y.-C., A.J.M., N.W., A.R.T.); Departments of Medical Biochemistry (M.W.) and Vascular Medicine (A.E.B.), Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands; and Haematopoiesis and Leukocyte Biology, Baker IDI Heart and Diabetes Institute, Melbourne, Australia (A.J.M.)
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49
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Pérez-Méndez Ó, Pacheco HG, Martínez-Sánchez C, Franco M. HDL-cholesterol in coronary artery disease risk: function or structure? Clin Chim Acta 2013; 429:111-22. [PMID: 24333390 DOI: 10.1016/j.cca.2013.12.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2013] [Revised: 11/29/2013] [Accepted: 12/01/2013] [Indexed: 12/29/2022]
Abstract
High-density lipoproteins (HDL) are inversely related with coronary artery disease (CAD) and HDL-cholesterol is the only standardized and reproducible parameter available to estimate plasma concentration of these lipoproteins. However, pharmacological interventions intended to increase HDL-cholesterol have not been consistently associated to an effective CAD risk reduction. Among patients with a myocardial infarction, 43 and 44% of men and women, respectively, had normal plasma levels of HDL-cholesterol, whereas genetic studies have failed to show a causal association between HDL-cholesterol and CAD risk. Instead, HDL functionality seems to be the target to be evaluated, but the existing methods are still poorly reproducible and far to be adapted to the clinical laboratory. HDL subclasses rise as a potential alternative for the evaluation of CAD risk; HDL subclasses are a surrogate of intravascular metabolism of these lipoproteins and probably of their functionality. Low levels of large HDL and increased proportions of small particles are the most remarkable features associated to an increased risk of type 2 diabetes mellitus (T2DM) or CAD. However, inflammation and other environmental factors are related with abnormal HDL structure, and, as a consequence, more prospective studies are needed to better support the clinical usefulness of HDL subclasses. New insights from proteome and lipidome profiles of HDL will provide potential HDL-related biomarkers in the coming years.
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Affiliation(s)
- Óscar Pérez-Méndez
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico.
| | - Héctor González Pacheco
- Department of Emergency, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico
| | - Carlos Martínez-Sánchez
- Department of Emergency, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico
| | - Martha Franco
- Department of Molecular Biology, National Institute of Cardiology "Ignacio Chávez", Mexico, DF, Mexico
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50
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Leman LJ, Maryanoff BE, Ghadiri MR. Molecules that mimic apolipoprotein A-I: potential agents for treating atherosclerosis. J Med Chem 2013; 57:2169-96. [PMID: 24168751 DOI: 10.1021/jm4005847] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Certain amphipathic α-helical peptides can functionally mimic many of the properties of full-length apolipoproteins, thereby offering an approach to modulate high-density lipoprotein (HDL) for combating atherosclerosis. In this Perspective, we summarize the key findings and advances over the past 25 years in the development of peptides that mimic apolipoproteins, especially apolipoprotein A-I (apoA-I). This assemblage of information provides a reasonably clear picture of the state of the art in the apolipoprotein mimetic field, an appreciation of the potential for such agents in pharmacotherapy, and a sense of the opportunities for optimizing the functional properties of HDL.
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Affiliation(s)
- Luke J Leman
- Department of Chemistry and The Skaggs Institute for Chemical Biology, The Scripps Research Institute , 10550 North Torrey Pines Road, La Jolla, California 92037, United States
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