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Sharif A, Mamo J, Lam V, Al-Salami H, Mooranian A, Watts GF, Clarnette R, Luna G, Takechi R. The therapeutic potential of probucol and probucol analogues in neurodegenerative diseases. Transl Neurodegener 2024; 13:6. [PMID: 38247000 PMCID: PMC10802046 DOI: 10.1186/s40035-024-00398-w] [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: 11/05/2023] [Accepted: 01/07/2024] [Indexed: 01/23/2024] Open
Abstract
Neurodegenerative disorders present complex pathologies characterized by various interconnected factors, including the aggregation of misfolded proteins, oxidative stress, neuroinflammation and compromised blood-brain barrier (BBB) integrity. Addressing such multifaceted pathways necessitates the development of multi-target therapeutic strategies. Emerging research indicates that probucol, a historic lipid-lowering medication, offers substantial potential in the realm of neurodegenerative disease prevention and treatment. Preclinical investigations have unveiled multifaceted cellular effects of probucol, showcasing its remarkable antioxidative and anti-inflammatory properties, its ability to fortify the BBB and its direct influence on neural preservation and adaptability. These diverse effects collectively translate into enhancements in both motor and cognitive functions. This review provides a comprehensive overview of recent findings highlighting the efficacy of probucol and probucol-related compounds in the context of various neurodegenerative conditions, including Alzheimer's disease, Parkinson's disease, Huntington's disease, and cognitive impairment associated with diabetes.
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Affiliation(s)
- Arazu Sharif
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - John Mamo
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Perron Institute for Neurological and Translational Research, Perth, WA, Australia
| | - Virginie Lam
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Hani Al-Salami
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Armin Mooranian
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Gerald F Watts
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - Roger Clarnette
- School of Medicine, Faculty of Health and Medical Sciences, University of Western Australia, Perth, WA, Australia
| | - Giuseppe Luna
- Curtin Medical School, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Ryu Takechi
- Curtin Health Innovation Research Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
- School of Public Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia.
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Hafiane A, Ronca A, Kiss RS, Favari E. High Density Lipoprotein-Based Therapeutics: Novel Mechanism of Probucol in Foam Cells. Front Cardiovasc Med 2022; 9:895031. [PMID: 35557540 PMCID: PMC9086955 DOI: 10.3389/fcvm.2022.895031] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 03/29/2022] [Indexed: 11/13/2022] Open
Affiliation(s)
- Anouar Hafiane
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
- *Correspondence: Anouar Hafiane
| | - Annalisa Ronca
- Department of Food and Drug, University of Parma, Parma, Italy
| | - Robert S. Kiss
- Research Institute of the McGill University Health Center, Montreal, QC, Canada
| | - Elda Favari
- Department of Food and Drug, University of Parma, Parma, Italy
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Hafiane A, Pisaturo A, Ronca A, Incerti M, Kiss RS, Favari E. Probucol treatment is associated with an ABCA1-independent mechanism of cholesterol efflux to lipid poor apolipoproteins from foam cell macrophages. BBA ADVANCES 2021; 1:100003. [PMID: 37082009 PMCID: PMC10074979 DOI: 10.1016/j.bbadva.2021.100003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
Objective Probucol is a cholesterol-lowering agent whose ability to prevent atherosclerosis is currently under study. Herein, we investigate the putative mechanism of probucol by observation of changes in cellular cholesterol efflux and lipid droplet morphology in macrophages. Results The inhibitory activity of probucol was assessed in non-foam or foam cell macrophages expressing ABCA1 generated by treatment with fetal calf serum (FCS) alone or in combination with acetylated LDL, respectively. Probucol inhibited cholesterol efflux to apolipoprotein A-I (apoA-I) by 31.5±0.1% in THP-1 non-foam cells and by 18.5±0.2% in foam cells. In probucol-treated non-foam THP-1 cells, nascent high density lipoprotein (nHDL) particles with a diameter < 7 nm were generated, while in probucol-treated THP-1 foam cells nHDL particles of > 7 nm in diameter containing cholesterol were produced. Foam cells also displayed a significant accumulation of free cholesterol at the plasma membrane, as measured by percent cholestenone formed. Intracellularly, there was a significant decrease in lipid droplet number and an increase in size in probucol-treated THP-1 foam cells when compared to non-treated cells. Conclusions We report for the first time that probucol is unable to completely inhibit cholesterol efflux in foam cells to the same extent as in non-foam cells. Indeed, functional nHDL is released from foam cells in the presence of probucol. This difference in inhibitory effect could potentially be explained by changes in the plasma membrane pool as well as intracellular cholesterol storage independently of ABCA1.
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Affiliation(s)
- Anouar Hafiane
- Research Institute, McGill University Health Center, Montreal, QC, Canada
- Corresponding author at: Department of Medicine, Faculty of Medicine, Research Institute of the McGill University Health Centre. 1001 boul Decarie, Montreal, Québec H3A 1A1, Canada.
| | | | | | | | - Robert S. Kiss
- Research Institute of the McGill University Health Center, Montreal, Canada and Department of Medicine, McGill University, Montreal, Canada
| | - Elda Favari
- Department of Food and Drug, University of Parma, Italy
- Corresponding author at: Department of Food and Drug, University of Parma, Parco Area delle Scienze, 27/A, 43124 Parma, Italy.
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Ganjali S, Momtazi-Borojeni AA, Banach M, Kovanen PT, Gotto AM, Sahebkar A. HDL functionality in familial hypercholesterolemia: effects of treatment modalities and pharmacological interventions. Drug Discov Today 2018; 23:171-180. [DOI: 10.1016/j.drudis.2017.09.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2017] [Revised: 09/02/2017] [Accepted: 09/25/2017] [Indexed: 01/14/2023]
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Yamashita S, Masuda D, Ohama T, Arai H, Bujo H, Kagimura T, Kita T, Matsuzaki M, Saito Y, Fukushima M, Matsuzawa Y. Rationale and Design of the PROSPECTIVE Trial: Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Prior Coronary Heart Disease. J Atheroscler Thromb 2016; 23:746-56. [PMID: 26803913 PMCID: PMC7399286 DOI: 10.5551/jat.32813] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 10/05/2015] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Reduction of serum LDL-cholesterol by statins was shown to improve clinical outcomes in patients with coronary heart disease (CHD). Although intensive statin therapy significantly reduced cardiovascular risks, atherosclerotic cardiovascular events have not been completely prevented. Therefore, effective pharmacologic therapy is necessary to improve "residual risks" in combination with statins. Probucol has a potent antioxidative effect, inhibits the oxidation of LDL, and reduces xanthomas. Probucol Trial for Secondary Prevention of Atherosclerotic Events in Patients with Prior Coronary Heart Disease (PROSPECTIVE) is a multicenter, randomized, prospective study designed to test the hypothesis that the addition of probucol to other lipid-lowering drugs will prevent cerebro- and cardiovascular events in patients with prior coronary events and high LDL cholesterol levels. STUDY DESIGN The study will recruit approximately 860 patients with a prior CHD and dyslipidemia with LDL-C level ≥140 mg/dl without any medication and those treated with any lipid-lowering drugs with LDL-C level ≥100 mg/dl. Lipid-lowering agents are continuously administered during the study period in control group, and probucol (500 mg/day, 250 mg twice daily) is added to lipid-lowering therapy in the test group. The efficacy and safety of probucol with regard to the prevention of cerebro- and cardiovascular events and the intima-media thickness of carotid arteries as a surrogate marker will be evaluated. SUMMARY PROSPECTIVE will determine whether the addition of probucol to other lipid-lowering drugs improves cerebro- and cardiovascular outcomes in patients with prior coronary heart disease. Furthermore, the safety of a long-term treatment with probucol will be clarified.
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Affiliation(s)
- Shizuya Yamashita
- Department of Community Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Rinku General Medical Center, Izumisano, Osaka, Japan
| | - Daisaku Masuda
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Tohru Ohama
- Department of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
- Department of Dental Anesthesiology, Osaka University Graduate School of Dentistry, Suita, Osaka, Japan
| | - Hidenori Arai
- The National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Hideaki Bujo
- Department of Clinical Laboratory and Experimental Research Medicine, Toho University, Sakura Medical Center, Sakura, Chiba, Japan
| | - Tatsuo Kagimura
- Foundation for Biomedical Research and Innovation, Kobe, Hyogo, Japan
| | - Toru Kita
- Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan
| | | | - Yasushi Saito
- Chiba University Graduate School of Medicine, Chiba, Japan
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Abstract
PURPOSE OF REVIEW Probucol is a potent antioxidative drug that has been used for prevention and treatment of atherosclerotic cardiovascular diseases and xanthoma. Probucol has been used as a lipid-lowering drug for a long time especially in Japan, although Western countries quitted its use because of the reduction in serum HDL-cholesterol (HDL-C). This review highlights both basic and clinical studies that provide new insights into the pleiotropic effects of probucol. RECENT FINDINGS Recently, the mechanisms for the pharmacologic actions of probucol have been elucidated at the molecular level with a special focus on HDL metabolism and its functions. Probucol enhances plasma cholesteryl ester transfer protein activity and hepatic scavenger receptor class B type I, causing a decrease in HDL-C. It also accelerates the antioxidative function of HDL via increase in paraoxonase 1 activity. Recent retrospective analyses of probucol-treated patients with heterozygous familial hypercholesterolemia and those after coronary revascularization demonstrated a strong beneficial effect of probucol on secondary prevention of cardiovascular events and mortality. SUMMARY Probucol has pleiotropic and beneficial therapeutic effects on cardiovascular system. Although statins are effective for lowering LDL-cholesterol (LDL-C) and reducing coronary heart disease risk, probucol should be considered as an option in case statins are not effective.
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Affiliation(s)
- Shizuya Yamashita
- aDepartment of Community Medicine bDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine cSumitomo Hospital, Osaka, Japan
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Niimi M, Keyamura Y, Nozako M, Koyama T, Kohashi M, Yasufuku R, Yoshikawa T, Fan J. Probucol inhibits the initiation of atherosclerosis in cholesterol-fed rabbits. Lipids Health Dis 2013; 12:166. [PMID: 24188322 PMCID: PMC4228370 DOI: 10.1186/1476-511x-12-166] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2013] [Accepted: 10/29/2013] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Probucol and statin are often prescribed for treating atherosclerosis. These two drugs exhibit different mechanisms but it is unknown whether they have the same anti-atherogenic properties. In the current study, we examined whether these two drugs at optimal doses could inhibit the initiation of atherosclerosis in cholesterol-fed rabbits in the same way. METHODS New Zealand White rabbits were fed a cholesterol-rich diet for 5 weeks to produce the early-stage lesions of atherosclerosis. Drug-treated rabbits were administered either probucol or atorvastatin and serum lipids and aortic atherosclerotic lesions were compared with those in a control group. RESULTS Atorvastatin treatment significantly reduced serum total cholesterol levels while probucol treatment led to significant reduction of high-density lipoprotein cholesterol levels without changing total cholesterol levels compared with those in the control group. Compared with the control, probucol treatment led to 65% (p < 0.01) reduction while atorvastatin treatment led to 23% (p = 0.426) reduction of the aortic lesion area. Histological and immunohistochemical analyses revealed that the lesions of the probucol-treated group were characterized by remarkable reduction of monocyte adherence to endothelial cells and macrophage accumulation in the intima compared with those of both atorvastatin and control groups. Furthermore, low-density lipoprotein (LDL) isolated from the probucol group exhibited prominent anti-oxidative reaction, which was not present in LDL isolated from either the atorvastatin-treated or the control group. CONCLUSIONS This study suggests that probucol inhibits the initiation of atherosclerosis by reducing monocyte adherence and infiltration into the subintima. Anti-oxidization of LDL by probucol protects more effectively against early-stage lesion formation than statin-mediated lipid-lowering effects.
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Affiliation(s)
- Manabu Niimi
- Department of Molecular Pathology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
| | - Yuka Keyamura
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Masanori Nozako
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Takashi Koyama
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Masayuki Kohashi
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Reiko Yasufuku
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Tomohiro Yoshikawa
- Free Radical Research Project, Otsuka Pharmaceutical Co., Ltd., Tokushima, Japan
| | - Jianglin Fan
- Department of Molecular Pathology, Interdisciplinary Graduate School of Medicine and Engineering, University of Yamanashi, Yamanashi, Japan
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Fukami T, Ishii T, Io T, Suzuki N, Suzuki T, Yamamoto K, Xu J, Ramamoorthy A, Tomono K. Nanoparticle Processing in the Solid State Dramatically Increases the Cell Membrane Permeation of a Cholesterol-Lowering Drug, Probucol. Mol Pharm 2009; 6:1029-35. [DOI: 10.1021/mp9000487] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Toshiro Fukami
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Tatsuya Ishii
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Takeshi Io
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Naoto Suzuki
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Toyofumi Suzuki
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Kazutoshi Yamamoto
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Jiadi Xu
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Ayyalusamy Ramamoorthy
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
| | - Kazuo Tomono
- College of Pharmacy, Nihon University, Chiba 274-8555, Japan, and Department of Pharmaceutical Sciences, College of Pharmacy, Biophysics and Department of Chemistry, University of Michigan, Ann Arbor, Michigan 48109
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Moghadasian MH. Dietary phytosterols reduce probucol-induced atherogenesis in apo E-KO mice. Atherosclerosis 2006; 188:28-34. [PMID: 16325824 DOI: 10.1016/j.atherosclerosis.2005.10.021] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2005] [Revised: 08/09/2005] [Accepted: 10/07/2005] [Indexed: 11/19/2022]
Abstract
We have previously shown strong pro-atherogenic effects of probucol in apolipoprotein E-knockout (apo E-KO) mice. The aims of the present study were to investigate whether (a) dietary phytosterols reduce probucol-induced atherogenesis and (b) beneficial interactions exist between these agents. Male apo E-KO mice fed with an atherogenic diet supplemented with phytosterols or probucol or their combination for 14 weeks. Single therapy with either phytosterols or probucol resulted in a 25% reduction in plasma total cholesterol (TC) concentrations as compared to the control group. The effects of the combination therapy were more profound (60% reduction). While phytosterols reduced atherogenesis by 60%, probucol caused an increase of 150% in atherogenesis. Addition of phytosterols to probucol substantially reduced pro-atherogenic effects of probucol. This was associated with improved high density lipoprotein (HDL) concentrations. The ratio of TC to HDL cholesterol was markedly reduced in the combination therapy group as compared to the probucol-treated group. A strong positive association between the ratio of TC to HDL cholesterol and the extent of atherosclerotic lesions was observed. The coronary arteries of the probucol-treated group showed various stages of atherogenesis from infiltration of monocytes into intima to complete occlusion of the vessel by atheromatous lesions. Such pathological findings were not observed in the combination therapy group. Approximately 40% of the mice in the probucol-treated group and 10% of the animals in the combination therapy group developed skin lesions. Further studies warrant the investigation of the underlying mechanisms of the observed beneficial interactions between dietary phytosterols and probucol.
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Affiliation(s)
- Mohammed H Moghadasian
- Departments of Human Nutritional Sciences and Pathology, The University of Manitoba, Winnipeg, Man., Canada R2H 2A6.
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Burnett JR, Watts GF. New therapies for familial hypercholesterolemia. Expert Opin Ther Pat 2006. [DOI: 10.1517/13543776.16.3.349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Nagano M, Nakamura M, Kobayashi N, Kamata J, Hiramori K. Effort Angina in a Middle-Aged Woman With Abnormally High Levels of Serum High-Density Lipoprotein Cholesterol A Case of Cholesteryl-Ester Transfer Protein Deficiency. Circ J 2005; 69:609-12. [PMID: 15849450 DOI: 10.1253/circj.69.609] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
A 54-year-old female was admitted to hospital complaining of oppressive anterior chest pain during exercise. Treadmill exercise ECG testing showed significant ischemic ECG changes, and electron-beam computed tomography demonstrated patchy calcifications in the coronary artery. Coronary angiography revealed a significant stenotic lesion of the right coronary artery. On routine investigations, no classical coronary risk factors were found, although a very high concentration (209 mg/dl) of high-density lipoprotein cholesterol (HDL-C) was detected. The serum concentration of cholesteryl-ester transfer protein (CETP), which plays a central role in the reverse cholesterol transport system, was measured and found to be less than the measurable minimum. The patient showed one of the typical genetic CETP mutations (intone 14 splicing defect), and her lipid profile was improved by administration of probucol for 3 months. A very high concentration of HDL-C with a defect of CETP activity may be a specific biochemical indicator pointing to an increased risk of premature coronary artery disease, and the lipid profile can be improved by use of lipid-lowering drugs.
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Affiliation(s)
- Masahide Nagano
- Second Department of Internal Medicine, Iwate Medical University School of Medicine, Japan
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Le Goff W, Guerin M, Chapman MJ. Pharmacological modulation of cholesteryl ester transfer protein, a new therapeutic target in atherogenic dyslipidemia. Pharmacol Ther 2004; 101:17-38. [PMID: 14729390 DOI: 10.1016/j.pharmthera.2003.10.001] [Citation(s) in RCA: 87] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
In mediating the transfer of cholesteryl esters (CE) from antiatherogenic high density lipoprotein (HDL) to proatherogenic apolipoprotein (apo)-B-containing lipoprotein particles (including very low density lipoprotein [VLDL], VLDL remnants, intermediate density lipoprotein [IDL], and low density lipoprotein [LDL]), the CE transfer protein (CETP) plays a critical role not only in the reverse cholesterol transport (RCT) pathway but also in the intravascular remodeling and recycling of HDL particles. Dyslipidemic states associated with premature atherosclerotic disease and high cardiovascular risk are characterized by a disequilibrium due to an excess of circulating concentrations of atherogenic lipoproteins relative to those of atheroprotective HDL, thereby favoring arterial cholesterol deposition and enhanced atherogenesis. In such states, CETP activity is elevated and contributes significantly to the cholesterol burden in atherogenic apoB-containing lipoproteins. In reducing the numbers of acceptor particles for HDL-derived CE, both statins (VLDL, VLDL remnants, IDL, and LDL) and fibrates (primarily VLDL and VLDL remnants) act to attenuate potentially proatherogenic CETP activity in dyslipidemic states; simultaneously, CE are preferentially retained in HDL and thereby contribute to elevation in HDL-cholesterol content. Mutations in the CETP gene associated with CETP deficiency are characterized by high HDL-cholesterol levels (>60 mg/dL) and reduced cardiovascular risk. Such findings are consistent with studies of pharmacologically mediated inhibition of CETP in the rabbit, which argue strongly in favor of CETP inhibition as a valid therapeutic approach to delay atherogenesis. Consequently, new organic inhibitors of CETP are under development and present a potent tool for elevation of HDL in dyslipidemias involving low HDL levels and premature coronary artery disease, such as the dyslipidemia of type II diabetes and the metabolic syndrome. The results of clinical trials to evaluate the impact of CETP inhibition on premature atherosclerosis are eagerly awaited.
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Affiliation(s)
- Wilfried Le Goff
- Institut National de la Santé et de la Recherche Médicale (INSERM) Unité 551, "Dyslipoproteinemia and Atherosclerosis: Genetics, Metabolism and Therapy", Hôpital de la Pitié, 83 boulevard de l'Hôpital, 75651 Cedex 13, Paris, France
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Davidson J, Rotondo D. Lipid metabolism. Curr Opin Lipidol 2001; 12:355-7. [PMID: 11353339 DOI: 10.1097/00041433-200106000-00016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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