1
|
Vachal P, Duffy JL, Campeau LC, Amin RP, Mitra K, Murphy BA, Shao PP, Sinclair PJ, Ye F, Katipally R, Lu Z, Ondeyka D, Chen YH, Zhao K, Sun W, Tyagarajan S, Bao J, Wang SP, Cote J, Lipardi C, Metzger D, Leung D, Hartmann G, Wollenberg GK, Liu J, Tan L, Xu Y, Chen Q, Liu G, Blaustein RO, Johns DG. Invention of MK-8262, a Cholesteryl Ester Transfer Protein (CETP) Inhibitor Backup to Anacetrapib with Best-in-Class Properties. J Med Chem 2021; 64:13215-13258. [PMID: 34375108 DOI: 10.1021/acs.jmedchem.1c00959] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Cholesteryl ester transfer protein (CETP) represents one of the key regulators of the homeostasis of lipid particles, including high-density lipoprotein (HDL) and low-density lipoprotein (LDL) particles. Epidemiological evidence correlates increased HDL and decreased LDL to coronary heart disease (CHD) risk reduction. This relationship is consistent with a clinical outcomes trial of a CETP inhibitor (anacetrapib) combined with standard of care (statin), which led to a 9% additional risk reduction compared to standard of care alone. We discuss here the discovery of MK-8262, a CETP inhibitor with the potential for being the best-in-class molecule. Novel in vitro and in vivo paradigms were integrated to drug discovery to guide optimization informed by a critical understanding of key clinical adverse effect profiles. We present preclinical and clinical evidence of MK-8262 safety and efficacy by means of HDL increase and LDL reduction as biomarkers for reduced CHD risk.
Collapse
Affiliation(s)
- Petr Vachal
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Joseph L Duffy
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Louis-Charles Campeau
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Rupesh P Amin
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Kaushik Mitra
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Beth Ann Murphy
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Pengcheng P Shao
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Peter J Sinclair
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Feng Ye
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Revathi Katipally
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Zhijian Lu
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Debra Ondeyka
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Yi-Heng Chen
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Kake Zhao
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Wanying Sun
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Sriram Tyagarajan
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Jianming Bao
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Sheng-Ping Wang
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Josee Cote
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Concetta Lipardi
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Daniel Metzger
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Dennis Leung
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Georgy Hartmann
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Gordon K Wollenberg
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Jian Liu
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Lushi Tan
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Yingju Xu
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Qinghao Chen
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Guiquan Liu
- WuXi AppTec, 90 Delin Rd., Waigaoqiao Free Trade Zone, Shanghai 200131, China
| | - Robert O Blaustein
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| | - Douglas G Johns
- Merck & Co., Inc., 2000 Galloping Hill Rd., Kenilworth, New Jersey 07033, United States
| |
Collapse
|
2
|
Masuda D, Yamashita S. Serum HDL-Cholesterol Level Does Not Influence Cardiovascular Event Rate under Sufficient Lowering of LDL-Cholesterol by Pitavatatin in Patients with Stable Coronary Artery Disease. J Atheroscler Thromb 2021; 29:8-10. [PMID: 33762513 PMCID: PMC8737075 DOI: 10.5551/jat.ed165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
|
3
|
Travanut A, Monteiro PF, Oelmann S, Howdle SM, Grabowska AM, Clarke PA, Ritchie AA, Meier MAR, Alexander C. Synthesis of Passerini-3CR Polymers and Assembly into Cytocompatible Polymersomes. Macromol Rapid Commun 2020; 42:e2000321. [PMID: 33249682 DOI: 10.1002/marc.202000321] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 07/22/2020] [Indexed: 12/15/2022]
Abstract
The versatility of the Passerini three component reaction (Passerini-3CR) is herein exploited for the synthesis of an amphiphilic diblock copolymer, which self-assembles into polymersomes. Carboxy-functionalized poly(ethylene glycol) methyl ether is reacted with AB-type bifunctional monomers and tert-butyl isocyanide in a single process via Passerini-3CR. The resultant diblock copolymer (P1) is obtained in good yield and molar mass dispersity and is well tolerated in model cell lines. The Passerini-3CR versatility and reproducibility are shown by the synthesis of P2, P3, and P4 copolymers. The ability of the Passerini P1 polymersomes to incorporate hydrophilic molecules is verified by loading doxorubicin hydrochloride in P1DOX polymersomes. The flexibility of the synthesis is further demonstrated by simple post-functionalization with a dye, Cyanine-5 (Cy5). The obtained P1-Cy5 polymersomes rapidly internalize in 2D cell monolayers and penetrate deep into 3D spheroids of MDA-MB-231 triple-negative breast cancer cells. P1-Cy5 polymersomes injected systemically in healthy mice are well tolerated and no visible adverse effects are seen under the conditions tested. These data demonstrate that new, biodegradable, biocompatible polymersomes having properties suitable for future use in drug delivery can be easily synthesized by the Passerini-3CR.
Collapse
Affiliation(s)
- Alessandra Travanut
- School of Pharmacy, University of Nottingham, Boots Science Building, University Park, Nottingham, NG7 2RD, UK
| | - Patrícia F Monteiro
- School of Pharmacy, University of Nottingham, Boots Science Building, University Park, Nottingham, NG7 2RD, UK
| | - Stefan Oelmann
- Karlsruhe Institute of Technology, Materialwissenschaftliches Zentrum, Straße am Forum 7, Building 30.48, 76131, Karlsruhe, Germany
| | - Steven M Howdle
- School of Chemistry, University of Nottingham, University Park, Nottingham, NG7 2RD, UK
| | - Anna M Grabowska
- Division of Cancer and Stem Cells, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Philip A Clarke
- Division of Cancer and Stem Cells, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Alison A Ritchie
- Division of Cancer and Stem Cells, University of Nottingham, Nottingham, NG7 2UH, UK
| | - Michael A R Meier
- Karlsruhe Institute of Technology, Materialwissenschaftliches Zentrum, Straße am Forum 7, Building 30.48, 76131, Karlsruhe, Germany
| | - Cameron Alexander
- School of Pharmacy, University of Nottingham, Boots Science Building, University Park, Nottingham, NG7 2RD, UK
| |
Collapse
|
4
|
Takubo H, Ishikawa T, Taniguchi T, Iwanaga K, Nomura Y. The influence of multiple oral administration on the pharmacokinetics and distribution profile of dalcetrapib in rats. Xenobiotica 2020; 51:82-87. [PMID: 32783571 DOI: 10.1080/00498254.2020.1809030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
We investigated the influence of multiple oral administration on the accumulation of dalcetrapib (JTT-705/RO4607381), a novel cholesteryl ester transfer protein inhibitor, in rats. It is well known that orally administered dalcetrapib is rapidly hydrolysed to its active form, which has a sulfhydryl group, in the body. The active form then binds covalently to endogenous thiols via mixed disulfide bonds. Following multiple once daily oral administration of 14C-dalcetrapib for seven days to rats, the concentration of radioactivity in the plasma and almost all tissues reached the steady state by day 4. At 24 h after the last dose, there was a relatively high concentration of radioactivity in the mesenteric lymph nodes, liver, adrenal glands and fat. After the last dose to rats, the radioactivity was almost completely recovered in the urine and faeces, indicating that dalcetrapib is not retained in the body, probably due to the reversibility of the disulfide bonds despite being covalent bonds.
Collapse
Affiliation(s)
- Hiroaki Takubo
- Drug Metabolism and Pharmacokinetics Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc, Osaka, Japan
| | - Tomohiro Ishikawa
- Drug Metabolism and Pharmacokinetics Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc, Osaka, Japan
| | - Toshio Taniguchi
- Drug Metabolism and Pharmacokinetics Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc, Osaka, Japan
| | - Kazunori Iwanaga
- Education and Research Center for Clinical Pharmacy, Osaka University of Pharmaceutical Sciences, Osaka, Japan
| | - Yukihiro Nomura
- Drug Metabolism and Pharmacokinetics Research Laboratories, Central Pharmaceutical Research Institute, Japan Tobacco Inc, Osaka, Japan
| |
Collapse
|
5
|
Tanner L, Haynes RK, Wiesner L. Accumulation of TB-Active Compounds in Murine Organs Relevant to Infection by Mycobacterium tuberculosis. Front Pharmacol 2020; 11:724. [PMID: 32508649 PMCID: PMC7248252 DOI: 10.3389/fphar.2020.00724] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Accepted: 04/30/2020] [Indexed: 12/23/2022] Open
Abstract
Tuberculosis (TB), the leading cause of death due to an infectious agent, requires prolonged and costly drug treatments. With the rise in incidence of MDR and XDR TB, newer more efficacious treatments which are better able to permeate into the deeper recesses of the human lung where bacteria reside are urgently required. To this end, two new promising drug candidates, the decoquinate derivative RMB041 and the phenoxazine PhX1, were assessed for their abilities to permeate into specific murine organs. In particular, PhX1 permeation into the lungs and heart was notably efficient, as reflected in the high relative AUC values of 9669 ± 120.2 min/nmol/mg and 12450 ± 45.2 min/nmol/mg for lung and heart tissue, respectively. However, neither compound maintained a free concentration in the lung which exceeded the compound’s respective MIC90 values, indicating the importance of correcting for organ specific binding.
Collapse
Affiliation(s)
- Lloyd Tanner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| | - Richard K Haynes
- Centre of Excellence for Pharmaceutical Sciences, Faculty of Health Sciences, North-West University, Potchefstroom, South Africa
| | - Lubbe Wiesner
- Division of Clinical Pharmacology, Department of Medicine, University of Cape Town, Cape Town, South Africa
| |
Collapse
|
6
|
Abstract
The applications of fluorine in drug design continue to expand, facilitated by an improved understanding of its effects on physicochemical properties and the development of synthetic methodologies that are providing access to new fluorinated motifs. In turn, studies of fluorinated molecules are providing deeper insights into the effects of fluorine on metabolic pathways, distribution, and disposition. Despite the high strength of the C-F bond, the departure of fluoride from metabolic intermediates can be facile. This reactivity has been leveraged in the design of mechanism-based enzyme inhibitors and has influenced the metabolic fate of fluorinated compounds. In this Perspective, we summarize the literature associated with the metabolism of fluorinated molecules, focusing on examples where the presence of fluorine influences the metabolic profile. These studies have revealed potentially problematic outcomes with some fluorinated motifs and are enhancing our understanding of how fluorine should be deployed.
Collapse
Affiliation(s)
- Benjamin M Johnson
- Pharmaceutical Candidate Optimization, Bristol Myers Squibb Company, 100 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Yue-Zhong Shu
- Pharmaceutical Candidate Optimization, Bristol Myers Squibb Company, Route 206 and Province Line Road, Princeton, New Jersey 08543, United States
| | - Xiaoliang Zhuo
- Pharmaceutical Candidate Optimization, Bristol Myers Squibb Company, 100 Binney Street, Cambridge, Massachusetts 02142, United States
| | - Nicholas A Meanwell
- Discovery Chemistry Platforms, Small Molecule Drug Discovery, Bristol Myers Squibb Company, Route 206 and Province Line Road, Princeton, New Jersey 08543, United States
| |
Collapse
|
7
|
Johns DG, Wang S, Rosa R, Hubert J, Xu S, Chen Y, Bateman T, Blaustein RO. Impact of drug distribution into adipose on tissue function: The cholesteryl ester transfer protein (CETP) inhibitor anacetrapib as a test case. Pharmacol Res Perspect 2019; 7:e00543. [PMID: 31832204 PMCID: PMC6857080 DOI: 10.1002/prp2.543] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 10/11/2019] [Accepted: 10/15/2019] [Indexed: 12/28/2022] Open
Abstract
Anacetrapib is an inhibitor of cholesteryl ester transfer protein (CETP) previously under development as a lipid-modifying agent that reduces LDL-cholesterol and increases HDL-cholesterol in hypercholesterolemic patients. Anacetrapib demonstrates a long terminal half-life and accumulates in adipose tissue, which contributes to a long residence time of anacetrapib. Given our previous report that anacetrapib distributes into the lipid droplet of adipose tissue, we sought to understand whether anacetrapib affected adipose function, using a diet-induced obese (DIO) mouse model. Following 20 weeks of treatment with anacetrapib (100 mg/kg/day), levels of the drug increased to approximately 0.6 mmol/L in white adipose tissue. This level of anacetrapib was not associated with any impairment in adipose functionality as evidenced by a lack of any reduction in biomarkers of adipose functionality (plasma adiponectin, leptin, insulin; adipose adiponectin, leptin mRNA). In DIO wild-type (WT) mice treated with anacetrapib for 2 weeks and then subjected to 30% food restriction during washout to induce weight loss (18%) and fat mass loss (7%), levels of anacetrapib in adipose and plasma were not different between food restricted and ad lib-fed mice. These data indicate that despite deposition and long-term residence of ~0.6 mmol/L levels of anacetrapib in adipose tissue, adipose tissue function appears to be unaffected in mice. In addition, these data also indicate that even with severe caloric restriction and acute loss of fat mass, anacetrapib does not appear to be mobilized from the fat depot, thereby solidifying the role of adipose as a long-term storage site of anacetrapib.
Collapse
Affiliation(s)
- Douglas G. Johns
- Department of Translational PharmacologyMerck & Co., Inc.KenilworthNJUSA
| | - Sheng‐Ping Wang
- Department of Cardiometabolic Diseases/AtherosclerosisMerck & Co., Inc.KenilworthNJUSA
| | - Raymond Rosa
- Department of Cardiometabolic Diseases/AtherosclerosisMerck & Co., Inc.KenilworthNJUSA
| | - James Hubert
- Department of Cardiometabolic Diseases/AtherosclerosisMerck & Co., Inc.KenilworthNJUSA
| | - Suoyu Xu
- Department of Pharmacokinetics, Pharmacodynamics and Drug MetabolismMerck & Co., Inc.KenilworthNJUSA
| | - Ying Chen
- Department of Cardiometabolic Diseases/AtherosclerosisMerck & Co., Inc.KenilworthNJUSA
| | - Thomas Bateman
- Department of Pharmacokinetics, Pharmacodynamics and Drug MetabolismMerck & Co., Inc.KenilworthNJUSA
| | | |
Collapse
|
8
|
Johns DG, LeVoci L, Krsmanovic M, Lu M, Hartmann G, Xu S, Wang SP, Chen Y, Bateman T, Blaustein RO. Characterization of Anacetrapib Distribution into the Lipid Droplet of Adipose Tissue in Mice and Human Cultured Adipocytes. Drug Metab Dispos 2018; 47:227-233. [DOI: 10.1124/dmd.118.084525] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 11/29/2018] [Indexed: 01/01/2023] Open
|
9
|
Smith DA, van Waterschoot RA, Parrott NJ, Olivares-Morales A, Lavé T, Rowland M. Importance of target-mediated drug disposition for small molecules. Drug Discov Today 2018; 23:2023-2030. [DOI: 10.1016/j.drudis.2018.06.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 06/04/2018] [Accepted: 06/12/2018] [Indexed: 11/30/2022]
|
10
|
Ferri N, Corsini A, Sirtori CR, Ruscica M. Present therapeutic role of cholesteryl ester transfer protein inhibitors. Pharmacol Res 2018; 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] [What about the content of this article? (0)] [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.
Collapse
|
11
|
Affiliation(s)
| | - Kevin Beaumont
- Medicine Design, Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Tristan S. Maurer
- Medicine Design, Pfizer Inc., Cambridge, Massachusetts 02139, United States
| | - Li Di
- Medicine Design, Pfizer Inc., Groton, Connecticut 06340, United States
| |
Collapse
|
12
|
Krishna R, Gheyas F, Liu Y, Hagen DR, Walker B, Chawla A, Cote J, Blaustein RO, Gutstein DE. Chronic Administration of Anacetrapib Is Associated With Accumulation in Adipose and Slow Elimination. Clin Pharmacol Ther 2017; 102:832-840. [DOI: 10.1002/cpt.700] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 03/14/2017] [Accepted: 03/28/2017] [Indexed: 11/07/2022]
Affiliation(s)
- R Krishna
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - F Gheyas
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - Y Liu
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - DR Hagen
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - B Walker
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - A Chawla
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | - J Cote
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| | | | - DE Gutstein
- MRL, Merck & Co., Inc.; Kenilworth New Jersey
| |
Collapse
|
13
|
Affiliation(s)
- Claudio Borghi
- Medical and Surgical Sciences Dept., University of Bologna, Bologna, Italy
| | | |
Collapse
|
14
|
Abstract
PURPOSE OF REVIEW To re-evaluate the functions of plasma cholesteryl ester transfer protein (CETP) in atherosclerosis based upon recent findings from human genetics and pharmacological CETP manipulation. RECENT FINDINGS CETP is involved in the transfer of cholesteryl ester from HDL to apolipoprotein B-containing lipoproteins, a key step of reverse cholesterol transport (RCT). CETP inhibitors have been developed to raise serum HDL-cholesterol (HDL-C) levels and reduce cardiovascular events. However, outcome studies of three CETP inhibitors (torcetrapib, dalcetrapib and evacetrapib) were prematurely terminated because of increased mortality or futility despite marked increases in HDL-cholesterol and decreases in LDL-cholesterol except for dalcetrapib. Patients with CETP deficiency show remarkable changes in HDL and LDL and are sometimes accompanied by atherosclerotic cardiovascular diseases. Recent prospective epidemiological studies demonstrated atheroprotective roles of CETP. CETP inhibition induces formation of small dense LDL and possibly dysfunctional HDL and downregulates hepatic scavenger receptor class B type I (SR-BI). Therefore, CETP inhibitors may interrupt LDL receptor and SR-BI-mediated cholesterol delivery back to the liver. SUMMARY For future drug development, the opposite strategy, namely enhancers of RCT via CETP and SR-BI activation as well as the inducers of apolipoprotein A-I or HDL production might be a better approach rather than delaying HDL metabolism by inhibiting a main stream of RCT in vivo.
Collapse
Affiliation(s)
- Shizuya Yamashita
- aDepartment of Community Medicine bDepartment of Cardiovascular Medicine, Osaka University Graduate School of Medicine, Suita cRinku General Medical Center, Izumisano dSumitomo Hospital, Kita-ku, Osaka, Japan
| | | |
Collapse
|