Abstract

High levels of plasma high-density lipoprotein-cholesterol (HDL-C) are inversely associated with the risk of atherosclerosis and other cardiovascular diseases; thus, pharmacological inhibition of cholesteryl ester transfer protein (CETP) is considered to be a therapeutic method of raising HDL-C levels. However, many CETP inhibitors have failed to achieve a clinical benefit despite raising HDL-C. In the study, we generated transgenic (Tg) rabbits that overexpressed the human CETP gene to examine the influence of CETP on the development of atherosclerosis. Both Tg rabbits and their non-Tg littermates were fed a high cholesterol diet for 16 weeks. Plasma lipids and body weight were measured every 4 weeks. Gross lesion areas of the aortic atherosclerosis along with lesional cellular components were quantitatively analyzed. Overexpression of human CETP did not significantly alter the gross atherosclerotic lesion area, but the number of macrophages in lesions was significantly increased. Overexpression of human CETP did not change the plasma levels of total cholesterol or low-density lipoprotein cholesterol but lowered plasma HDL-C and increased triglycerides. These data revealed that human CETP may play an important role in the development of atherosclerosis mainly by decreasing HDL-C levels and increasing the accumulation of macrophage-derived foam cells.

Highlights

  • Epidemiological studies have clearly shown that a low highdensity lipoprotein cholesterol (HDL-C) level is a strong and independent risk factor for the development of cardiovascular disease (CAD) [1]

  • Our results showed that increased expression of human CETP (hCETP) increased the accumulation of macrophage-derived foam cells in atherosclerotic lesions

  • We successfully generated Tg rabbits (Tg) expressing hCETP confirmed by polymerase chain reaction (PCR) genotyping (Figures 1(b) and 1(c))

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Summary

Introduction

Epidemiological studies have clearly shown that a low highdensity lipoprotein cholesterol (HDL-C) level is a strong and independent risk factor for the development of cardiovascular disease (CAD) [1]. Pharmaceutical CETP inhibitors such as Torcetrapib [3] and Dalcetrapib [4] have been shown to raise HDL-C levels effectively, but research into their clinical efficacy was terminated due to off-target effect or lack of clinical benefit. A meta-analysis suggested that Evacetrapib, either as a monotherapy or in combination with a statin, reduces lowdensity lipoprotein cholesterol (LDL-C) and increases HDL-C levels without affecting TG concentrations [5] but has no clinical benefit [6]. The newer CETP inhibitors, Anacetrapib and TA-8995, have shown promising effects on the lipid profile and metabolism (increase in HDL-C and reduction in LDL-C levels), but their cardiovascular effects and safety profile have not yet been confirmed in large outcome trials [7]. Despite an increase in HDL-C and a reduction in Mediators of Inflammation

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