Novel derivatives of monascus pigment having a high CETP inhibitory activity.

The cholesteryl ester transfer protein (CETP), inhibition of which assists in maintaining a high level of high-density lipoprotein cholesterol in the blood, is a target for anti-atherosclerosis treatments. Orange monascus pigment was produced by a Monascus species in a 5 L jar fermenter and various derivative compounds were synthesised by incorporating 19 different L-amino acids into the orange pigment. Among them, the L-Thr and L-Tyr derivatives exhibited high inhibitory activities against the CETP reaction. The inhibitory activities of the L-Thr and L-Tyr derivatives increased in a dose-dependent manner, resulting in IC50 values of 1.0 and 2.3 µM, respectively. When CETP reactions in the presence of the derivatives were performed, the inhibition modes of the L-Thr and L-Tyr derivatives were non-competitive with inhibition constant (Ki) values of 2.7 and 4.3 µM, respectively.

Evaluation of lipids, drug concentration, and safety parameters following cessation of treatment with the cholesteryl ester transfer protein inhibitor anacetrapib in patients with or at high risk for coronary heart disease.

The aim of this study was to assess the effects on lipids and safety during a 12-week reversal period after 18 months of treatment with anacetrapib. The cholesteryl ester transfer protein inhibitor anacetrapib was previously shown to reduce low-density lipoprotein cholesterol by 39.8% (estimated using the Friedewald equation) and increase high-density lipoprotein (HDL) cholesterol by 138.1%, with an acceptable side-effect profile, in patients with or at high risk for coronary heart disease in the Determining the Efficacy and Tolerability of CETP Inhibition With Anacetrapib (DEFINE) trial. A total of 1,398 patients entered the 12-week reversal-phase study, either after completion of the active-treatment phase or after early discontinuation of the study medication. In patients allocated to anacetrapib, placebo-adjusted mean percentage decreases from baseline were observed at 12 weeks off the study drug for Friedewald-calculated low-density lipoprotein cholesterol (18.6%), non-HDL cholesterol (17.6%), and apolipoprotein B (10.2%); placebo-adjusted mean percentage increases were observed for HDL cholesterol (73.0%) and apolipoprotein A-I (24.5%). Residual plasma anacetrapib levels (about 40% of on-treatment apparent steady-state trough levels) were also detected 12 weeks after cessation of anacetrapib. No clinically important elevations in liver enzymes, blood pressure, electrolytes, or adverse experiences were observed during the reversal phase. Preliminary data from a small cohort (n = 30) revealed the presence of low concentrations of anacetrapib in plasma 2.5 to 4 years after the last anacetrapib dose. In conclusion, after the cessation of active treatment, anacetrapib plasma lipid changes and drug levels decreased to approximately 40% of on-treatment trough levels at 12 weeks after dosing, but modest HDL cholesterol elevations and low drug concentrations were still detectable 2 to 4 years after the last dosing.

Efecto de la expresión de la PTEC, el gemfibrozilo y la rosiglitazona en el transporte inverso de colesterol desde macrófagos a heces in vivo / The effect of human CETP activity, gemfibroziland rosiglitazone on macrophage-specific reverse cholesterol transport in vivo

Introducción. La expresión de PTEC humana enratones transgénicos reduce el colesterol de las lipoproteínas de alta densidad (cHDL) y aumenta la susceptibilidad a la arteriosclerosis. Por otro lado, el gemfibrozilo, uno de los fibratos más utilizados en clínica, y la rosiglitazona aumentan el cHDL y reducen la susceptibilidad a la arteriosclerosis en modelos murinos. El objetivo principal de este estudio es evaluar el efecto de la expresión de la PTEC humana, el gemfibrozilo y la rosiglitazona en el transporte inverso de colesterol(TIC) específico de macrófagos. Materiales y método. Para determinar el TIC específico de macrófagos se aplicó inyección intraperitoneal de macrófagos P388D1 marcados con 3H-colesterol en ratones controles (C57BL/6) y ratones transgénicos de PTEC humana. Este mismo proceso se realizó en ratones transgénicos de apoA-I humana (h) que recibieron una dosis diaria por vía oral de gemfibrozilo (625 mg/kg) orosiglitazona (10 mg/kg) durante 17 días y se los comparó con los que recibieron la solución vehículo. A las 48 h, se sacrificó a los animales y se determinó el 3H-colesterol en plasma, hígado y heces. Resultados. Los ratones transgénicos de PTEC humana presentaron una disminución significativa de cHDL en plasma respecto a los ratones controles. El gemfibrozilo incrementó el colesterol total y el cHDL en los ratones transgénicos deapoA-Ih. Sin embargo, ni la expresión de PTEC humana ni los tratamientos farmacológicos alteraron la excreción fecal de colesterol y ácidos biliares. No se encontraron diferencias significativas en el TIC de 3H-colesterol desde los macrófagos P388D1 a heces en los diferentes grupos experimentales. Conclusiones. Ni la expresión de PTEC humana en ratones transgénicos ni el tratamiento congemfibrozilo o rosiglitazona en ratones transgénicos de apoA-Ih modifican el transporte inverso de colesterol especifico de macrófagos in vivo (AU)

Background. Human CETP expression in micereduces cholesterol from high density lipoprotein HDLc) and increases atherosclerosis susceptibility. On the other hand, gemfibrozil, one of the most used fibrates in clinical practice, and rosiglitazone, increase HDLc and reduce the atherosclerotic susceptibility in mouse models of atherosclerosis. The main aim of this study was to evaluate the effect of human CETP expression, and the effect of gemfibrozil or rosiglitazone treatment on one of the most important HDL anti-atherogenic properties, the macrophage-specific reverse cholesterol transport (RCT).Materials and method. To determinate the macrophage-specific RCT, [3H]cholesterol-labelledP388D1 macrophages were injected intraperitoneally into control mice (C57BL/6) and into human CETP transgenic mice. We performed the same procedure in human apoA-I transgenic mice treated during 17 days with an oral daily gavage dose of gemfibrozil (625 mg/kg),rosiglitazone (10 mg/kg) or vehicle solution. At 48h, the mice were euthanized and [3H]cholesterol in plasma, liver and faeces were measured. Results. Human CETP transgenic mice showed decreased HDLc compared to control mice. Human apoA-I transgenic mice showed an increase in total cholesterol and HDLc when treated with gemfibrozil, but not with rosiglitazone. Neither the human CETP activity, nor either of the two pharmacological treatments altered faecal cholesterol or bile acid excretion. Furthermore, the[3H]tracer detected in liver, faecal cholesterol and bile acid was not significantly different in any of the animal groups. Conclusions. Neither human CETP expression intransgenic mice, nor treatment with gemfibrozil orrosiglitazone in human apoA-I transgenic micemodified macrophage-specific reverse cholesterol transport (AU)

Pharmacokinetics, metabolism, and excretion of torcetrapib, a cholesteryl ester transfer protein inhibitor, in humans.

The pharmacokinetics, metabolism, and excretion of torcetrapib, a selective inhibitor of human cholesteryl ester transfer protein, were investigated in healthy human male volunteers after oral administration of [(14)C]torcetrapib (120-mg dose). The total mean recovery of radiolabeled dose after 21 days was 75.7%, and most of the dose (63%) was excreted in the urine. The total circulating radioactivity and unchanged torcetrapib plasma concentrations increased over the first 6 h and then declined slowly with mean terminal elimination half-lives of 373 and 211 h. Metabolism of torcetrapib was extensive in humans. Only 5.2% of the total dose constituted unchanged torcetrapib in the feces, whereas no parent was excreted unchanged in the urine. Similarly, pharmacokinetic analysis of total radioactivity and unchanged torcetrapib revealed that the area under the concentration versus time curve from zero to infinity of torcetrapib accounted for approximately 7.0% of the circulating radioactivity. Torcetrapib was metabolized to numerous metabolites via oxidation. The primary metabolic pathway involved initial oxidative decarbamoylation followed by extensive further oxidation, resulting in the formation of bistrifluoromethylbenzoic acid (M1) and quinaldic acid (M4) metabolites. A mean 40% of the total dose was excreted in the urine as M4 (and its glucuronide and urea conjugates), whereas 7.0% of the total dose was excreted as M1. In vitro studies using human subcellular fractions suggested that the initial metabolism of torcetrapib proceeds via CYP3A-mediated decarbamoylation. Subsequent oxidations lead to the major circulating and excretory metabolites M1 and M4.