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Barkas F, Elisaf M, Klouras E, Dimitriou T, Tentolouris N, Liberopoulos E. Statin escape phenomenon: Fact or fiction? World J Exp Med 2017; 7:25-30. [PMID: 28261552 PMCID: PMC5316901 DOI: 10.5493/wjem.v7.i1.25] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 12/10/2016] [Accepted: 01/02/2017] [Indexed: 02/06/2023] Open
Abstract
AIM To evaluate the presence of the so called "statin escape" phenomenon among hyperlipidemic subjects attending a lipid clinic. METHODS This was a retrospective analysis of 1240 hyperlipidemic individuals followed-up for ≥ 3 years. We excluded those individuals meeting one of the following criteria: Use of statin therapy at baseline visit, discontinuation of statin treatment at most recent visit, change in statin treatment during follow-up and poor compliance to treatment. Statin escape phenomenon was defined as an increase in low-density lipoprotein cholesterol (LDL-C) levels at the most recent visit by > 10% compared with the value at 6 mo following initiation of statin treatment. RESULTS Of 181 eligible subjects, 31% exhibited the statin escape phenomenon. No major differences regarding baseline characteristics were found between statin escapers and non-statin escapers. Both escapers and non-escapers had similar baseline LDL-C levels [174 (152-189) and 177 (152-205) mg/dL, respectively]. In comparison with non-escapers, statin escapers demonstrated lower LDL-C levels at 6 mo after treatment initiation [88 (78-97) mg/dL vs 109 (91-129) mg/dL, P < 0.05], but higher levels at the most recent visit [103 (96-118) mg/dL vs 94 (79-114) mg/dL, P < 0.05]. CONCLUSION These data confirm the existence of an escape phenomenon among statin-treated individuals. The clinical significance of this phenomenon remains uncertain.
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Ota T, Ishii H, Suzuki S, Shibata Y, Tatami Y, Harata S, Shimbo Y, Takayama Y, Tanaka A, Kawamura Y, Osugi N, Maeda K, Kondo T, Murohara T. Impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction: Subgroup analysis of the Nagoya Acute Myocardial Infarction Study (NAMIS). Atherosclerosis 2015; 242:155-60. [PMID: 26188539 DOI: 10.1016/j.atherosclerosis.2015.07.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 06/04/2015] [Accepted: 07/06/2015] [Indexed: 12/15/2022]
Abstract
BACKGROUND Statins are reportedly effective in the primary and secondary prevention of cardiovascular disease, mainly due to their ability to aggressively reduce low-density lipoprotein cholesterol (LDL-C) levels. However, patients sometimes exhibit the so-called "statin escape" phenomenon. The purpose of our study was to investigate the impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction (AMI). METHOD This was a subgroup analysis of 1144 patients from the Nagoya Acute Myocardial Infarction Study (NAMIS) treated between January 2004 and December 2012. We analyzed 660 patients who initiated statin treatment after AMI. Statin escape phenomenon was defined as an increase in the LDL-C levels during the 9-month treatment period by >10% of the initial values after 4 weeks of initiating statin treatment. Patients were divided into two groups depending on whether they exhibited the statin escape phenomenon, with 474 patients in the non-escape group and 186 patients in the escape group. RESULT Compared to the non-escape group, the escape group showed significantly lower LDL-C levels at 4 weeks after treatment initiation (81.3 ± 20.1 mg/dL vs. 101.1 ± 25.4 mg/dL, P < 0.01). By contrast, the escape group showed significantly higher LDL-C levels at 9 months after treatment initiation (105.8 ± 28.3 mg/dL vs. 90.3 ± 22.6 mg/dL, P < 0.01). Major adverse cardiac and cerebrovascular events (MACCE; a composite of all-cause death, MI, and stroke) were more frequent in the escape group than in the non-escape group (10.8% vs. 6.1%, P = 0.03). Multivariate analysis showed that statin escape phenomenon was an independent predictor of MACCE (hazard ratio: 2.02, 95% confidence interval: 1.11-3.66, P = 0.02). CONCLUSION Statin escape phenomenon may be an independent predictor of long-term clinical outcomes in AMI patients.
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Affiliation(s)
- Tomoyuki Ota
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Hideki Ishii
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Susumu Suzuki
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohei Shibata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yosuke Tatami
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Shingo Harata
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yusaku Shimbo
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yohei Takayama
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Akihito Tanaka
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yoshihiro Kawamura
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naohiro Osugi
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Kengo Maeda
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Takahisa Kondo
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Toyoaki Murohara
- Department of Cardiology, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Ramos-Sanchez EM, Goto H, Rivero DHRF, Mauad T, de Souza FN, Monteiro AM, Gidlund M. In vivo assessment of antiretroviral therapy-associated side effects. Mem Inst Oswaldo Cruz 2014; 109:484-7. [PMID: 25075786 PMCID: PMC4155852 DOI: 10.1590/0074-0276130559] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2013] [Accepted: 04/08/2014] [Indexed: 12/11/2022] Open
Abstract
Antiretroviral therapy has been associated with side effects, either from the drug itself or in conjunction with the effects of human immunodeficiency virus infection. Here, we evaluated the side effects of the protease inhibitor (PI) indinavir in hamsters consuming a normal or high-fat diet. Indinavir treatment increased the hamster death rate and resulted in an increase in triglyceride, cholesterol and glucose serum levels and a reduction in anti-oxLDL auto-antibodies. The treatment led to histopathological alterations of the kidney and the heart. These results suggest that hamsters are an interesting model for the study of the side effects of antiretroviral drugs, such as PIs.
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Affiliation(s)
- Eduardo Milton Ramos-Sanchez
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Hiro Goto
- Instituto de Medicina Tropical, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
| | | | - Thais Mauad
- Departamento de Patologia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Fernando Nogueira de Souza
- Departamento de Clínica Médica, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Andrea Moreira Monteiro
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
| | - Magnus Gidlund
- Departamento de Imunologia, Instituto de Ciências Biomédicas, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brasil
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Matralis AN, Kourounakis AP. Design of Novel Potent Antihyperlipidemic Agents with Antioxidant/Anti-inflammatory Properties: Exploiting Phenothiazine’s Strong Antioxidant Activity. J Med Chem 2014; 57:2568-81. [DOI: 10.1021/jm401842e] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Alexios N. Matralis
- Department of Medicinal Chemistry,
School of Pharmacy, University of Athens, 15771 Athens, Greece
| | - Angeliki P. Kourounakis
- Department of Medicinal Chemistry,
School of Pharmacy, University of Athens, 15771 Athens, Greece
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Zambad SP, Tuli D, Mathur A, Ghalsasi SA, Chaudhary AR, Deshpande S, Gupta RC, Chauthaiwale V, Dutt C. TRC210258, a novel TGR5 agonist, reduces glycemic and dyslipidemic cardiovascular risk in animal models of diabesity. Diabetes Metab Syndr Obes 2013; 7:1-14. [PMID: 24379686 PMCID: PMC3873233 DOI: 10.2147/dmso.s50209] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND Patients with diabesity have a significantly increased risk of developing cardiovascular disease. Therefore, therapy addressing the multiple metabolic abnormalities linked with diabesity and leading to further reduction of cardiovascular risk is highly desirable. Activation of the TGR5 receptor holds therapeutic potential for diabesity. In the present study, we evaluated the efficacy of TRC210258, a novel TGR5 agonist, in clinically relevant animal models of diabesity. METHODS A novel small molecule, TRC210258 (N-(4-chlorophenyl)-2-(4-fluorophenoxy)-N-methylimidazo (1, 2-a) pyrimidine-3-carboxamide), was synthesized. The in vitro TGR5 receptor activation potential of TRC210258 was assessed by cyclic adenosine monophosphate (cAMP) assay and cAMP-responsive element reporter assay using cells overexpressing the human TGR5 receptor. The effect of TRC210258 on glucagon-like peptide-1 release was evaluated in vitro using a human enteroendocrine cell line. The effect of TRC210258 on energy expenditure and glycemic control was evaluated in high-fat diet-induced obese mice. Additionally, the effect of TRC210258 on dyslipidemic parameters was determined in high fat-fed hamsters. RESULTS TRC210258 demonstrated potent TGR5 agonist activity, with enhanced glucagon-like peptide-1 release and energy expenditure. Treatment with TRC210258 resulted in better glycemic control and improved parameters of dyslipidemia such as plasma triglyceride, low-density lipoprotein cholesterol, and non-high-density lipoprotein cholesterol levels. Treatment with TRC210258 also improved emerging dyslipidemic cardiovascular risk parameters, including remnant cholesterol and triglyceride clearance. CONCLUSION This study highlights the potential of TRC210258, a novel TGR5 agonist, to improve dyslipidemic cardiovascular risk beyond glycemic control in patients with type 2 diabetes.
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Affiliation(s)
| | - Davinder Tuli
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
| | - Anoop Mathur
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
| | - Sameer A Ghalsasi
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
| | - Anita R Chaudhary
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
| | | | - Ramesh C Gupta
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
| | - Vijay Chauthaiwale
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
- Correspondence: Vijay Chauthaiwale, Torrent Research Centre, Torrent Pharmaceuticals Ltd, PO Bhat, Gandhinagar, Gujarat, 382 428, India, Tel +91 79 2396 9100 ext 571, Fax +91 79 2396 9135, Email
| | - Chaitanya Dutt
- Torrent Research Centre, Torrent Pharmaceuticals Ltd, Gujarat, India
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Castro-Perez J, Briand F, Gagen K, Wang SP, Chen Y, McLaren DG, Shah V, Vreeken RJ, Hankemeier T, Sulpice T, Roddy TP, Hubbard BK, Johns DG. Anacetrapib promotes reverse cholesterol transport and bulk cholesterol excretion in Syrian golden hamsters. J Lipid Res 2011; 52:1965-73. [PMID: 21841206 PMCID: PMC3196228 DOI: 10.1194/jlr.m016410] [Citation(s) in RCA: 72] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2011] [Revised: 07/29/2011] [Indexed: 11/20/2022] Open
Abstract
Cholesteryl ester transfer protein (CETP) transfers cholesteryl ester (CE) and triglyceride between HDL and apoB-containing lipoproteins. Anacetrapib (ANA), a reversible inhibitor of CETP, raises HDL cholesterol (HDL-C) and lowers LDL cholesterol in dyslipidemic patients; however, the effects of ANA on cholesterol/lipoprotein metabolism in a dyslipidemic hamster model have not been demonstrated. To test whether ANA (60 mg/kg/day, 2 weeks) promoted reverse cholesterol transport (RCT), ³H-cholesterol-loaded macrophages were injected and (3)H-tracer levels were measured in HDL, liver, and feces. Compared to controls, ANA inhibited CETP (94%) and increased HDL-C (47%). ³H-tracer in HDL increased by 69% in hamsters treated with ANA, suggesting increased cholesterol efflux from macrophages to HDL. ³H-tracer in fecal cholesterol and bile acids increased by 90% and 57%, respectively, indicating increased macrophage-to-feces RCT. Mass spectrometry analysis of HDL from ANA-treated hamsters revealed an increase in free unlabeled cholesterol and CE. Furthermore, bulk cholesterol and cholic acid were increased in feces from ANA-treated hamsters. Using two independent approaches to assess cholesterol metabolism, the current study demonstrates that CETP inhibition with ANA promotes macrophage-to-feces RCT and results in increased fecal cholesterol/bile acid excretion, further supporting its development as a novel lipid therapy for the treatment of dyslipidemia and atherosclerotic vascular disease.
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Affiliation(s)
- Jose Castro-Perez
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
- Division of Analytical Biosciences, Netherlands Metabolomics Centre, Leiden, The Netherlands
| | - François Briand
- Physiogenex, Prologue Biotech, Labege-Innopole cedex, France
| | - Karen Gagen
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Sheng-Ping Wang
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Ying Chen
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - David G. McLaren
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Vinit Shah
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Rob J. Vreeken
- Division of Analytical Biosciences, Netherlands Metabolomics Centre, Leiden, The Netherlands
- LACDR, Leiden University, Leiden, The Netherlands
| | - Thomas Hankemeier
- Division of Analytical Biosciences, Netherlands Metabolomics Centre, Leiden, The Netherlands
- LACDR, Leiden University, Leiden, The Netherlands
| | - Thierry Sulpice
- Physiogenex, Prologue Biotech, Labege-Innopole cedex, France
| | - Thomas P. Roddy
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Brian K. Hubbard
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
| | - Douglas G. Johns
- Department of Cardiovascular Diseases, Atherosclerosis, Merck Research Laboratories, Rahway, NJ
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7
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Horvat S, Mcwhir J, Rozman D. Defects in cholesterol synthesis genes in mouse and in humans: lessons for drug development and safer treatments. Drug Metab Rev 2011; 43:69-90. [DOI: 10.3109/03602532.2010.540580] [Citation(s) in RCA: 52] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Kindt E, Wetterau J, Mueller SB, Castle C, Boustany-Kari CM. Quantitative sphingosine measurement as a surrogate for total ceramide concentration-preclinical and potential translational applications. Biomed Chromatogr 2010; 24:752-8. [PMID: 19908207 DOI: 10.1002/bmc.1359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Biomarkers are an increasingly important constituent of the drug development process, offering the potential of increased efficiency through reduced compound attrition and earlier proof of mechanism and/or efficacy. Assays developed for compound screening that can be directly translated for clinical trials are especially valuable, but their successful adoption requires a careful balance between assay performance and implementation costs. One such 'fit-for-purpose' biomarker assay, the indirect measurement of pharmacological modulation of sphingolipid biosynthesis and disposition, is presented here. Among sphingolipids, numerous ceramide species are readily detectable in different lipoprotein fractions of mammalian plasma, but their parallel quantification can be prohibitively expensive and time consuming. Ceramides differ in their fatty acid moiety, which is readily removed by hydrolysis, yielding a common sphingosine derivative, the measurement of which serves as an indicator of total ceramide. When followed by liquid chromatography tandem mass spectrometry (LC/MS/MS) for detection, robust analyte quantification becomes relatively straightforward. The practical utility of a method developed to be fit for the purpose of rapidly and quantitatively measuring treatment-induced variations in total ceramide from hamster plasma and individual lipoprotein fractions is described. With a linear calibration range from 0.003 to 33.4 microm sphingosine, precision and accuracy error in plasma-based quality controls spiked with ceramides was less than 15%. The specificity of the assay for ceramides was also assessed. The simplicity of the method would allow for its potential translation to other preclinical species, as well as for clinical applications in later-stage drug development.
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Affiliation(s)
- Erick Kindt
- Department of Pharmacokinetics, Dynamics, and Metabolism, Pfizer Inc., La Jolla, CA, USA
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Do R, Kiss RS, Gaudet D, Engert JC. Squalene synthase: a critical enzyme in the cholesterol biosynthesis pathway. Clin Genet 2009; 75:19-29. [DOI: 10.1111/j.1399-0004.2008.01099.x] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Elsayed RK, Evans JD. Emerging lipid-lowering drugs: squalene synthase inhibitors. Expert Opin Emerg Drugs 2008; 13:309-22. [DOI: 10.1517/14728214.13.2.309] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Tavridou A, Kaklamanis L, Papalois A, Kourounakis AP, Rekka EA, Kourounakis PN, Charalambous A, Manolopoulos VG. EP2306 [2-(4-Biphenyl)-4-methyl-octahydro-1,4-benzoxazin-2-ol, hydrobromide], A Novel Squalene Synthase Inhibitor, Reduces Atherosclerosis in the Cholesterol-Fed Rabbit. J Pharmacol Exp Ther 2007; 323:794-804. [PMID: 17804677 DOI: 10.1124/jpet.107.126375] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
EP2306 [2-(4-biphenyl)-4-methyl-octahydro-1,4-benzoxazin-2-ol, hydrobromide] inhibits squalene synthase and lipid biosynthesis and possesses antioxidant properties. We hypothesized that EP2306 can effectively modify circulating lipids and reduce atherosclerosis in the cholesterol-fed rabbit. Animals were fed a high-cholesterol diet for 4 weeks followed by 4 (phase 1 and 2) or 12 weeks (phase 3) of drug treatment while on high-cholesterol diet. In phase 1, the dose-effect relationship of EP2306 on lipids and atherosclerosis was established, and its most effective dose was determined (2 mg/kg). This dose reduced significantly total cholesterol (512 +/- 96 mg/dl before versus 320 +/- 124 mg/dl after treatment, p < 0.05) and atherosclerotic lesions compared with control animals. In phase 2, the effects of 2 mg/kg EP2306, 2.5 mg/kg simvastatin, and their combination were assessed. Although no significant effect on lipid parameters was observed, there was a significant reduction (35 +/- 5%, p < 0.05) of atherosclerotic lesions in animals treated with EP2306, a similar reduction with simvastatin, and a further reduction (48 +/- 7%, p < 0.05) when the two agents were combined. In animals treated for 12 weeks with the drugs (phase 3), only EP2306 significantly reduced atherosclerotic lesions by more than 50%, whereas simvastatin alone or in combination with EP2306 had no effect. Treatment with EP2306 did not adversely affect liver transaminases or cause any histopathological changes on various organs of the animals. In conclusion, we have shown that EP2306 inhibits atherosclerosis in vivo, indicating potential as a novel therapeutic agent for coronary artery disease and other atherosclerosis-related disorders.
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Affiliation(s)
- Anna Tavridou
- Laboratory of Pharmacology, Medical School, Democritus University of Thrace, Dragana Campus, 68100 Alexandroupolis, Greece
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