Cardiovascular Antisense Drug Discovery Group, Isis Pharmaceuticals, Carlsbad, CA 92010.
J Lipid Res. 2013 Mar;54(3):602-614. doi: 10.1194/jlr.M029215. Epub 2012 Dec 6.
Therapeutic agents that suppress apolipoprotein B (apoB) and microsomal triglyceride transfer protein (MTP) levels/activity are being developed in the clinic to benefit patients who are unable to reach target LDL-C levels with maximally tolerated lipid-lowering drugs. To compare and contrast the metabolic consequences of reducing these targets, murine-specific apoB or MTP antisense oligonucleotides (ASOs) were administered to chow-fed and high fat-fed C57BL/6 or to chow-fed and Western diet-fed LDLr⁻/⁻ mice for periods ranging from 2 to 12 weeks, and detailed analyses of various factors affecting fatty acid metabolism were performed. Administration of these drugs significantly reduced target hepatic mRNA and protein, leading to similar reductions in hepatic VLDL/triglyceride secretion. MTP ASO treatment consistently led to increases in hepatic triglyceride accumulation and biomarkers of hepatotoxicity relative to apoB ASO due in part to enhanced expression of peroxisome proliferator activated receptor γ target genes and the inability to reduce hepatic fatty acid synthesis. Thus, although both drugs effectively lowered LDL-C levels in mice, the apoB ASO produced a more positive liver safety profile.
正在临床开发能够抑制载脂蛋白 B (apoB) 和微粒体甘油三酯转移蛋白 (MTP) 水平/活性的治疗药物,以造福那些即使使用最大耐受剂量的降脂药物仍无法达到 LDL-C 目标水平的患者。为了比较和对比降低这些靶点的代谢后果,给喂食标准饮食和高脂肪饮食的 C57BL/6 小鼠或喂食标准饮食和西方饮食的 LDLr⁻/⁻ 小鼠施用了鼠特异性 apoB 或 MTP 反义寡核苷酸 (ASO),时间从 2 周到 12 周不等,并对影响脂肪酸代谢的各种因素进行了详细分析。这些药物的给药显著降低了靶肝 mRNA 和蛋白,导致肝 VLDL/甘油三酯分泌的相似降低。由于过氧化物酶体增殖物激活受体 γ 靶基因表达增强以及无法降低肝内脂肪酸合成,MTP ASO 治疗相对于 apoB ASO 始终导致肝内甘油三酯积累和肝毒性生物标志物增加。因此,尽管这两种药物都能有效地降低小鼠的 LDL-C 水平,但 apoB ASO 产生了更积极的肝脏安全性特征。