Advances in the Study of the Antiatherogenic Function and Novel Therapies for HDL

High-Density Lipoprotein Subfractions Remodeling: A Critical Process for the Treatment of Atherosclerotic Cardiovascular Diseases

Numerous studies have shown that a low level of high-density lipoprotein cholesterol (HDL-C) is an independent biomarker of cardiovascular disease. High-density lipoprotein (HDL) is considered to be a protective factor for atherosclerosis (AS). Therefore, raising HDL-C has been widely recognized as a promising strategy to treat atherosclerotic cardiovascular diseases (ASCVD). However, several studies have found that increasing HDL-C levels does not necessarily reduce the risk of ASCVD. HDL particles are highly heterogeneous in structure, composition, and biological function. Moreover, HDL particles from atherosclerotic patients exhibit impaired anti-atherogenic functions and these dysfunctional HDL particles might even promote ASCVD. This makes it uncertain that HDL-raising therapy will prevent and treat ASCVD. It is necessary to comprehensively analyze the structure and function of HDL subfractions. We review current advances related to HDL subfractions remodeling and highlight how current lipid-modifying drugs such as niacin, statins, fibrates, and cholesteryl ester transfer protein inhibitors regulate cholesterol concentration of HDL and specific HDL subfractions.

Predictive value of serum apolipoprotein A-I in the organ failure of acute pancreatitis: a retrospective cohort study

BACKGROUND

Organ failure (OF) largely governs the outcomes and mortality in patients with acute pancreatitis (AP), but there is a lack of optimal prognostic biomarker for OF. This study is designed to investigate whether the serum apolipoprotein A-I (Apo A-I) level can predict OF in patients with AP.

METHODS

A total of 424 patients with AP were reviewed in the study, and we finally got 228 patients eligible for analysis. Patients were divided into two groups based on serum Apo A-I level. Demographic information and clinical materials were retrospectively collected. The primary outcome was the occurrence of OF. Univariate and multivariate binary logistic regression were conducted to analyze the relationship between Apo A-I and OF. Additionally, we used receiver operating characteristic analysis to clarify the predictive value of serum Apo A-I level for OF and mortality.

RESULTS

Ninety-two patients and 136 patients were included in Apo A-I low and non-low groups, respectively. The occurrence of OF was significantly different in the two groups (35.9 vs. 9.6%, p < 0.001). Moreover, serum Apo A-I level markedly decreased across disease severity based on the 2012 Revised Atlanta Classification of AP. The decrease of serum apolipoprotein A-I was an independent risk factor for organ failure (OR: 6.216, 95% CI: 2.610, 14.806, p < 0.001). The area under the curve of serum Apo A-I was 0.828 and 0.889 for OF and mortality of AP, respectively.

CONCLUSIONS

Serum Apo A-I level in the early stage of the disease has a high predictive value for OF of AP.

Synthesis of Chitosan Oligosaccharide-Loaded Glycyrrhetinic Acid Functionalized Mesoporous Silica Nanoparticles and In Vitro Verification of the Treatment of APAP-Induced Liver Injury

OBJECTIVE

the study was to find a suitable treatment for acute drug-induced liver injury. The use of nanocarriers can improve the therapeutic effect of natural drugs by targeting hepatocytes and higher loads.

METHODS

firstly, uniformly dispersed three-dimensional dendritic mesoporous silica nanospheres (MSNs) were synthesized. Glycyrrhetinic acid (GA) was covalently modified on MSN surfaces through amide bond and then loaded with COSM to form drug-loaded nanoparticles (COSM@MSN-NH₂-GA). The constructed drug-loaded nano-delivery system was determined by characterization analysis. Finally, the effect of nano-drug particles on cell viability was evaluated and the cell uptake in vitro was observed.

RESULTS

GA was successfully modified to obtain the spherical nano-carrier MSN-NH₂-GA (≤200 nm). The neutral surface charge improves its biocompatibility. MSN-NH₂-GA has high drug loading (28.36% ± 1.00) because of its suitable specific surface area and pore volume. In vitro cell experiments showed that COSM@MSN-NH₂-GA significantly enhanced the uptake of liver cells (LO2) and decreased the AST and ALT indexes.

CONCLUSION

this study demonstrated for the first time that formulation and delivery schemes using natural drug COSM and nanocarrier MSN have a protective effect on APAP-induced hepatocyte injury. This result provides a potential nano-delivery scheme for the targeted therapy of acute drug-induced liver injury.

The value of HDL subfractions in predicting cardiovascular outcomes in untreated, diabetic patients with stable coronary artery disease: An age- and gender-matched case-control study

OBJECTIVE

The aim of the present study was to examine the value of high-density lipoprotein (HDL) subfractions for predicting cardiovascular events (CVEs) in untreated type 2 diabetes mellitus (T2DM) patients with stable coronary artery disease (SCAD) using an age- and gender-matched case-control study.

METHODS

In total, 185 SCAD patients and 185 T2DM patients with SCAD were enrolled and subjected to a clinical follow-up of CVEs. HDL subfractions were analyzed using the Quantimetrix Lipoprint System. The relationship between HDL subfractions and CVEs in T2DM patients with SCAD was evaluated by Kaplan-Meier analysis and Cox proportional hazard models.

RESULTS

During a median 37.7-month follow-up, T2DM patients with SCAD had a higher percentage of CVEs compared to SCAD patients (p=0.039). The concentration of the combined intermediate and small HDL-C subfraction (defined as the mixed HDL subfraction) was related to the event incidence in T2DM patients with SCAD (p=0.004), and it was positively associated with increased CVEs even after adjustment in three models. Kaplan-Meier curve analysis indicated that T2DM patients with SCAD in the high mixed HDL subfraction group (>28 mg/dL) had lower event-free survival rates (p=0.008).

CONCLUSIONS

Elevated concentration of the mixed HDL subfraction concentration predicts events in T2DM patients with SCAD.

Nanochitosan Effect on Biomolecular, Hypolipidemic in Rats and Incorporation in Functional Yogurt

&lt;b&gt;Background and Objective:&lt;/b&gt; Chitosan has many functional properties and biological activities. This work aimed to prepare and characterize Chitosan Nanoparticles (CN). Then, evaluate the hypolipidemic and antioxidant effect of CN in rats. Incorporate CN in camel yogurt and evaluation of yogurt properties. &lt;b&gt;Materials and Methods:&lt;/b&gt; Chitosan Nanoparticles (CN) were prepared and analyzed for the size, zeta potential and poly Polydispersity Index (PDI). Total 24 rats were divided into 4 groups, the negative control group was fed on the basal diet and the positive control group was fed on a High-Fat Diet (HFD), the group I and II were fed on the HFD+(CC) or (CN). The feeding period was 6 weeks. Prepared and Characterization stirred camel yogurt fortified by CN. &lt;b&gt;Results:&lt;/b&gt; CN the size was 27.20 nm, ζ-potential+38.78. After the feeding period for CN and CC groups were a decrease in body weight, serum lipid profile and liver function in both tested groups and an increase in HDL-cholesterol and an increase in antioxidants in the CN group more than that in the CC group was observed. mRNA expression with qPCR for hepatic PPARγ, HL, GSS and CYP2E1 genes was performed to investigate the alterations in their levels after CN treatment on the liver of rats fed with HFD. &lt;b&gt;Conclusion:&lt;/b&gt; CN possesses the ability to improve the impairment of lipid metabolism as strongly associated with gene expressions related to lipogenesis and oxidative stress. Also, the addition of 2% CN to camel yogurt gave sensory acceptable and microbiological quality.

Discovery of a novel niacin-lipoic acid dimer N2L attenuating atherosclerosis and dyslipidemia with non-flushing effects

Niacin has been widely used as an antihyperlipidemic drug, but the flushing effect restricted its clinical application. Here, we developed novel niacin-lipoic acid dimers which lead to better lipid modulation, higher synergistic effects and less side effects. We utilized molecular docking simulation to design a novel series of niacin-lipoic acid dimers. The compound N-(2-(5-(1,2-dithiolan-3-yl)pentanamido)ethyl)nicotinamide (N2L) was selected for the in vitro and in vivo evaluation, including the agonist activity in CHO-hGPR109A cells, cell protective effects in HT22 and HUVECs cells, flushing effect in guinea pigs and rats, lipid modulation in C57BL/6 mice and high fat diet-rats and atherosclerotic lesions regulation in apolipoprotein E null mice. N2L worked as potent and selective agonists for the high affinity niacin receptor GPR109A. N2L retained antioxidation and cytoprotection of lipoic acid. In addition, N2L displayed a good therapeutic index regarding lipid modulation and atherosclerotic lesions regulation, and minimized niacin-induced vasodilation (flushing) effect in vivo. N2L showed effective treatment regarding to lipid regulation and atherosclerosis inhibition effects, also with excellent antioxidant effects, safety profiles and non-flushing. All these results suggest N2L promising application prospects in the drug development for the treatment of atherosclerosis.

Rethinking good cholesterol: a clinicians' guide to understanding HDL

Low HDL cholesterol dyslipidaemia affects about half of people with type 2 diabetes and represents a major independent risk factor for atherosclerotic cardiovascular disease. The "good cholesterol" label was coined decades ago on the basis of a presumed causal role of HDL cholesterol in atherosclerotic cardiovascular disease. However, this view has been challenged by the negative results of several studies of HDL cholesterol-raising drugs, creating a paradox for clinicians regarding the value of HDL cholesterol as a risk biomarker and therapeutic target, and seemingly contradicting decades of evidence substantiating an inverse relation between HDL cholesterol and cardiovascular disease risk. We seek to resolve this issue by revisiting the history of the HDL hypothesis, chronicling how this paradox is ultimately rooted in the progressive erroneous blurring of the distinction between HDL and HDL cholesterol. We describe the compositional complexity of HDL particles beyond their cholesterol cargo and focus on their role in lipid transport. We discuss the evidence regarding novel HDL functions, including effects on glucose metabolism, and speculate on the implications for type 2 diabetes. HDL cholesterol is an imperfect biomarker of a highly complex and multifunctional lipid transport system, and we should now consider how new HDL markers more causally linked to cardiovascular complications could be adapted for clinical use. In the absence of a superior alternative, HDL cholesterol generally has value as a component of primary cardiovascular disease risk prediction models, including in people with type 2 diabetes. However, to avoid prognostic overgeneralisations, it is high time that the good cholesterol label is dropped.