Abstract 579: In vitro Models Concur With Clinical Results to Confirm Pleiotropic Mechanisms of Action for Gemcabene

Abstract

Introduction: Gemcabene, a fraudulent fatty acid, induces biological properties in nonclinical models, of which many translate to clinical findings in dyslipidemia patients. Its known mechanism of action includes reduction of the overall hepatic de novo triglyceride and cholesterol synthesis, and increase in VLDL clearance. Clinical benefits in various human populations infer that other mechanisms are involved that warrant evaluation. Methods and Results: We assessed the gemcabene effects in other molecular mechanistic models, particularly to study inhibition of human ATP Citrate Lyase (hACL), apolipoprotein gene expression in Sandwich-Cultured Transporter Certified TM Human Hepatocytes (SCHH), and expression of genes related to inflammation and cell signaling. Gemcabene, MEDICA-16, palmitic acid and their CoA thioesters were studied in a recombinant hACL in vitro assay system. Gemcabene-CoA thioester, but not the parent compound, inhibited recombinant hACL activity in vitro in a dose-dependent manner, in agreement with results obtained with palmitoyl-CoA and palmitic acid. Unlike palmitic acid, MEDICA-16, and bempedoic acid, gemcabene does not form a CoA ester in human hepatocytes: radioisotope studies show 98.8% parent gemcabene. Further, gemcabene potential on the gene expression of lipogenesis and inflammation markers was assessed in SCHH. Gemcabene showed significant regulation of HMG-CoA synthase 2 (HMGCS2) and CRP mRNAs. A marked induction response of the HMGCS2 mRNA content was observed, ranging from 2.26- to 2.73-fold (p ≤ 0.05) over control in SCHH treated with all concentrations of gemcabene (500, 1000, and 1500 μM). Also, a clear and statistically significant (p-value ≤ 0.05) concentration-related suppression response of CRP mRNA content was observed, ranging from (-2.58)- to (-2.65)-fold below control in SCHH treated with 1000 and 1500 μM gemcabene. Finally, RT-PCR analysis of liver samples from STAM TM mice treated with gemcabene revealed its downregulating effect on inflammatory, lipogenic, lipoprotein metabolism, and cell signaling genes: TNF-α, MCP-1, NF-κB, ApoC-III, and ACC1. Conclusion: Gemcabene manifests its pharmacological profile in lipid management and inflammation by multiple mechanisms of action.