Abstract

Inhibition of cholesteryl ester transfer protein (CETP) increases HDL cholesterol (HDL-C) levels. However, the circulating CETP level varies and the impact of its inhibition in species with high CETP levels on HDL structure and function remains poorly characterized. This study investigated the effects of dalcetrapib and anacetrapib, the two CETP inhibitors (CETPis) currently being tested in large clinical outcome trials, on HDL particle subclass distribution and cholesterol efflux capacity of serum in rabbits and monkeys. New Zealand White rabbits and vervet monkeys received dalcetrapib and anacetrapib. In rabbits, CETPis increased HDL-C, raised small and large α-migrating HDL, and increased ABCA1-induced cholesterol efflux. In vervet monkeys, although anacetrapib produced similar results, dalcetrapib caused opposite effects because the LDL-C level was increased by 42% and HDL-C decreased by 48% (P < 0.01). The levels of α- and preβ-HDL were reduced by 16% (P < 0.001) and 69% (P < 0.01), resulting in a decrease of the serum cholesterol efflux capacity. CETPis modulate the plasma levels of mature and small HDL in vivo and consequently the cholesterol efflux capacity. The opposite effects of dalcetrapib in different species indicate that its impact on HDL metabolism could vary greatly according to the metabolic environment.

Highlights

  • Inhibition of cholesteryl ester transfer protein (CETP) increases HDL cholesterol (HDL-C) levels

  • Dalcetrapib and anacetrapib caused reductions of CETP activity of 63% and 71%, respectively, indicating that the radioactive assay was not affected by the endogenous lipoprotein levels of the samples

  • Basal cholesterol efflux induced by apoB-depleted plasma was not modified by dalcetrapib (90 mg/kg/day) in monkeys, but decreased by 26% (P < 0.01) with 180 mg/kg/day (Fig. 8A), while anacetrapib-treated monkeys presented a marked increase (+44% and +43%, P < 0.001 at 3 and 10 mg/kg/day, respectively, Fig. 8B). These results suggest that the opposite modulation of HDL-C level by dalcetrapib and anacetrapib is associated with opposite changes in cholesterol efflux

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Summary

Introduction

Inhibition of cholesteryl ester transfer protein (CETP) increases HDL cholesterol (HDL-C) levels. This study investigated the effects of dalcetrapib and anacetrapib, the two CETP inhibitors (CETPis) currently being tested in large clinical outcome trials, on HDL particle subclass distribution and cholesterol efflux capacity of serum in rabbits and monkeys. Anacetrapib produced similar results, dalcetrapib caused opposite effects because the LDL-C level was increased by 42% and HDL-C decreased by 48% (P < 0.01). Dalcetrapib and anacetrapib differently impact HDL structure and function in rabbits and monkeys. HDL cholesterol (HDL-C) levels are inversely correlated with cardiovascular disease [1] This protective effect could be, at least in part, associated with the ability of HDL to remove cholesterol from peripheral tissues through a process called cholesterol efflux, the first step of reverse cholesterol transport (RCT) [2].

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