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Present therapeutic role of cholesteryl ester transfer protein inhibitors. Pharmacol Res 2017; 128:29-41. [PMID: 29287689 DOI: 10.1016/j.phrs.2017.12.028] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2017] [Revised: 12/24/2017] [Accepted: 12/24/2017] [Indexed: 12/16/2022]
Abstract
Therapeutic interventions aimed at increasing high-density lipoprotein (HDL) levels in order to reduce the residual cardiovascular (CV) risk of optimally drug treated patients have not provided convincing results, so far. Transfer of cholesterol from extrahepatic tissues to the liver appears to be the major atheroprotective function of HDL, and an elevation of HDL levels could represent an effective strategy. Inhibition of the cholesteryl ester transfer protein (CETP), raising HDL-cholesterol (HDL-C) and apolipoprotein A-I (apoA-I) levels, reduces low-density lipoprotein-cholesterol (LDL-C) and apoB levels, thus offering a promising approach. Despite the beneficial influence on cholesterol metabolism, off-target effects and lack of reduction in CV events and mortality (with torcetrapib, dalcetrapib and evacetrapib) highlighted the complex mechanism of CETP inhibition. After the failure of the above mentioned inhibitors in phase III clinical development, possibly due to the short duration of the trials masking benefit, the secondary prevention REVEAL trial has recently shown that the inhibitor anacetrapib significantly raised HDL-C (+104%), reduced LDL-C (-18%), with a protective effect on major coronary events (RR, 0.91; 95%CI, 0.85-0.97; p = 0.004). Whether LDL-C lowering fully accounts for the CV benefit or if HDL-C-rise is a crucial factor still needs to be determined, although the reduction of non-HDL (-18%) and Lp(a) (-25%), should be also taken into account. In spite of the positive results of the REVEAL Study, Merck decided not to proceed in asking regulatory approval for anacetrapib. Dalcetrapib (Dal-GenE study) and CKD-519 remain the two molecules within this area still in clinical development.
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Duwensee K, Schwaiger S, Tancevski I, Eller K, van Eck M, Markt P, Linder T, Stanzl U, Ritsch A, Patsch JR, Schuster D, Stuppner H, Bernhard D, Eller P. Leoligin, the major lignan from Edelweiss, activates cholesteryl ester transfer protein. Atherosclerosis 2011; 219:109-15. [PMID: 21820657 PMCID: PMC3212649 DOI: 10.1016/j.atherosclerosis.2011.07.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/01/2011] [Revised: 06/21/2011] [Accepted: 07/11/2011] [Indexed: 12/16/2022]
Abstract
Objective Cholesteryl ester transfer protein (CETP) plays a central role in the metabolism of high-density lipoprotein particles. Therefore, we searched for new drugs that bind to CETP and modulate its activity. Methods A preliminary pharmacophore-based parallel screening approach indicated that leoligin, a major lignan of Edelweiss (Leontopodium alpinum Cass.), might bind to CETP. Therefore we incubated leoligin ex vivo at different concentrations with human (n = 20) and rabbit plasma (n = 3), and quantified the CETP activity by fluorimeter. Probucol served as positive control. Furthermore, we dosed CETP transgenic mice with leoligin and vehicle control by oral gavage for 7 days and measured subsequently the in vivo modulation of CETP activity (n = 5 for each treatment group). Results In vitro, leoligin significantly activated CETP in human plasma at 100 pM (p = 0.023) and 1 nM (p = 0.042), respectively, whereas leoligin concentrations of 1 mM inhibited CETP activity (p = 0.012). The observed CETP activation was not species specific, as it was similar in magnitude for rabbit CETP. In vivo, there was also a higher CETP activity after oral dosage of CETP transgenic mice with leoligin (p = 0.015). There was no short-term toxicity apparent in mice treated with leoligin. Conclusion CETP agonism by leoligin appears to be safe and effective, and may prove to be a useful modality to alter high-density lipoprotein metabolism.
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Affiliation(s)
- Kristina Duwensee
- Department of Internal Medicine I, Innsbruck Medical University, Innsbruck, Austria
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Smith CJ, Ali A, Hammond ML, Li H, Lu Z, Napolitano J, Taylor GE, Thompson CF, Anderson MS, Chen Y, Eveland SS, Guo Q, Hyland SA, Milot DP, Sparrow CP, Wright SD, Cumiskey AM, Latham M, Peterson LB, Rosa R, Pivnichny JV, Tong X, Xu SS, Sinclair PJ. Biphenyl-Substituted Oxazolidinones as Cholesteryl Ester Transfer Protein Inhibitors: Modifications of the Oxazolidinone Ring Leading to the Discovery of Anacetrapib. J Med Chem 2011; 54:4880-95. [DOI: 10.1021/jm200484c] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Cameron J. Smith
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Amjad Ali
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Milton L. Hammond
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Hong Li
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Zhijian Lu
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Joann Napolitano
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Gayle E. Taylor
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Christopher F. Thompson
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Matt S. Anderson
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Ying Chen
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Suzanne S. Eveland
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Qiu Guo
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Sheryl A. Hyland
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Denise P. Milot
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Carl P. Sparrow
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Samuel D. Wright
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Anne-Marie Cumiskey
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Melanie Latham
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Laurence B. Peterson
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Ray Rosa
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - James V. Pivnichny
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Xinchun Tong
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Suoyu S. Xu
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
| | - Peter J. Sinclair
- Departments of Medicinal Chemistry, ‡Cardiovascular Diseases, §Pharmacology, and ∥Drug Metabolism, Merck Research Laboratories, Rahway, New Jersey 07065, United States
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