Grover Gary J, Egan Donald M, Sleph Paul G, Beehler Blake C, Chiellini Grazia, Nguyen Ngoc-Ha, Baxter John D, Scanlan Thomas S
Metabolic and Cardiovascular Drug Discovery, Bristol-Myers Squibb Pharmaceutical Research Institute, Pennington, New Jersey 08534, USA.
Endocrinology. 2004 Apr;145(4):1656-61. doi: 10.1210/en.2003-0973. Epub 2003 Dec 30.
Current drug therapies for obesity are ineffective, and existing treatments for lipid disorders can be further improved. Thyroid hormones affect both conditions, although currently available nonselective thyromimetics are not clinically useful for such treatment due to cardiac side effects. Recent studies suggest that thyroid hormone receptor subtype beta (TRbeta) selective agonists have a profile in which cholesterol can be reduced with minimal tachycardia. The purpose of this study was to determine whether modest (5-10%) increases in metabolic rate could also be observed with minimal tachycardia after TRbeta stimulation. For these studies, the TRbeta selective agonist, GC-1, was used to assess selectivity for lipid-lowering and metabolic rate changes relative to tachycardia. Studies in cholesterol-fed rats (7 d treatment) showed that GC-1 reduced cholesterol (ED(50) = 190 nmol/kg x d) approximately 30 times more potently than it induced tachycardia (ED(15) = 5451 nmol/kg x d). T(3) showed no potency difference between cholesterol lowering and tachycardia. GC-1 showed approximately 10-fold selectivity for increasing metabolic rate (ED(5) = 477 nmol/kg x d) relative to tachycardia compared with T(3), which showed no selectivity. In cynomolgus monkeys treated for 7 d, significant cholesterol-lowering and lipoprotein (a) reduction was noted for both T(3) and GC-1, whereas no tachycardia was observed for GC-1, unlike T(3). T(3) and GC-1 caused a significant (approximately 4%) reduction in body weight in these animals. Therefore, selective TRbeta activation may be a potentially usefully treatment for obesity and reduction of low density lipoprotein cholesterol and reduction of the atherogenic risk factor lipoprotein (a).
目前用于治疗肥胖症的药物疗法效果不佳,而现有的脂质紊乱治疗方法仍有改进空间。甲状腺激素对这两种病症均有影响,不过由于存在心脏副作用,目前可用的非选择性甲状腺模拟物在临床上并不适用于此类治疗。近期研究表明,甲状腺激素受体β亚型(TRβ)选择性激动剂具有这样一种特性:能在使心动过速降至最低的情况下降低胆固醇水平。本研究的目的是确定在TRβ刺激后,是否也能在使心动过速降至最低的情况下观察到代谢率适度(5 - 10%)的提高。在这些研究中,TRβ选择性激动剂GC - 1被用于评估相对于心动过速而言,其在降低血脂和改变代谢率方面的选择性。在喂食胆固醇的大鼠中进行的研究(7天治疗)表明,GC - 1降低胆固醇的效力(半数有效剂量[ED50] = 190 nmol/kg·d)比其诱发心动过速的效力(半数有效剂量[ED15] = 5451 nmol/kg·d)强约30倍。T3在降低胆固醇和诱发心动过速方面未显示出效力差异。与无选择性的T3相比,GC - 1在提高代谢率方面(半数有效剂量[ED5] = 477 nmol/kg·d)相对于心动过速表现出约10倍的选择性。在接受7天治疗的食蟹猴中,T3和GC - 1均显著降低了胆固醇水平并减少了脂蛋白(a),然而与T3不同的是,GC - 1未观察到心动过速。T3和GC - 1使这些动物的体重显著降低了约4%。因此,选择性激活TRβ可能是治疗肥胖症、降低低密度脂蛋白胆固醇以及降低致动脉粥样硬化风险因子脂蛋白(a)的一种潜在有效疗法。