Abstract 334: The LXRβ Selective Agonist, VTP-38443, Significantly Decreases Plaque Cholesterol Ester Content and Inflammation in a Murine Model of Accelerated Atherosclerosis

The ligand-activated transcription factors LXRα and LXRβ are important regulators of cholesterol metabolism and inflammation. Activation of LXR was previously shown to inhibit atherosclerosis in animal models through activation of reverse cholesterol transport (RCT) and suppression of vascular inflammation. VTP-38443 is a potent selective and orally bioavailable modulator of LXRβ that is being pursued for the prevention of subsequent vascular events following an acute coronary syndrome (ACS) episode. VTP-38443 is a potent binder (Ki=12 nM) and activator (EC50=17 nM) of LXRβ. It is ~20x selective for LXRβ versus LXRβ in both binding and activation. In primary human cells, it induces the expression of the cholesterol efflux pumps ABCA1 and ABCG1, markers of RCT, and promotes cholesterol efflux from human fibroblasts at low concentrations (EC50 = 14 nM). Orally dosed VTP-38443 demonstrates robust induction of ABCA1 and ABCG1 in mice (ED50 < 0.3 mg/kg) and primates (ED50 < 0.1 mg/kg). Based on this robust activity, VTP-38443 was tested in the apoE -/- carotid artery ligated mouse model, an accelerated atherosclerosis model. ApoE-/- mice (9 week) were fed a Western diet for 2 weeks at which point the left common carotid artery was ligated. Mice remained on the Western diet for 2 weeks post-surgery and were dosed BID with VTP-38443 (0.05, 0.2 and 1 mg/kg/dose) or a non-selective LXR agonist, TO90137 (20 mg/kg/day) during this time. Plasma cholesterol and TGs were measured as were cholesterol esters and FDG-6-phosphate, a biomarker of plaque inflammation, in the carotid plaques. VTP-38443 gave a dose-dependent reduction in plasma cholesterol (35% at 1 mg/kg) and a modest dose-dependent increase in plasma TGs ranging from 5% to 45% of the TG increase seen with TO90137. Plaque analysis showed a highly significant decrease in carotid cholesterol ester content at all doses, achieving >90% reduction at the highest dose. In addition, there was a significant reduction (~40-50%) in FDG-6 phosphate at all doses of VTP-38443, indicating a decrease in vascular inflammation. These data indicate that LXRβ activation may decrease plaque cholesterol content and reduce plaque inflammation in ACS.

Effects of hyaluronic acid and other glycosaminoglycans on fibrin polymer formation

Previously, we reported that the glycosaminoglycan (GAG) hyaluronic acid (HA) specifically bound to the plasma protein fibrinogen [LeBoeuf, R. D., Raja, R. R., Fuller, G. M., & Weigel, P. H. (1986) J. Biol. Chem. 261, 12586]. The binding of other macromolecules to fibrinogen could influence the conversion of fibrinogen to fibrin. Therefore, we tested whether HA and other GAGs could alter the kinetics of fibrin polymer formation and the physical structure of the resulting gel. In this study, we present data showing that the GAGs HA and chondroitin sulfate (CS) affect fibrin formation in three specific ways: (i) they decreased the clotting time of fibrinogen 3-10-fold; (ii) both GAGs increase significantly the rate of fibrin polymer formation; and (iii) fibrin gels containing HA or CS had a final A450 that was greater than controls, indicating that these two glycosaminoglycans influence either the final size of fibrin fibrils or the extent of the lateral association between fibrils. These results demonstrate that the interactions of HA and CS with forming fibrin polymers can alter both the kinetics of formation and may produce structural changes in fibrin gels.