Anacetrapib reduces (V)LDL-cholesterol by inhibition of CETP activity and reduction of plasma PCSK9

article
Recently, we showed in APOE*3-Leiden.CETP mice that anacetrapib attenuated atherosclerosis development by reducing (V)LDL-C rather than by raising HDL-C. Here, we investigated the mechanism by which anacetrapib reduces (V)LDL-C and whether this effect was dependent on the inhibition of CETP. APOE*3-Leiden.CETP mice were fed a Western type diet alone or supplemented with anacetrapib (30 mg/kg body weight/d). Microarray analyses of livers revealed down-regulation of the cholesterol biosynthesis pathway (P<0.001) and predicted down regulation of sterol regulatory element-binding protein-1 and -2 controlled pathways (z-score -2.56 and z-score -2.90, respectively; both P<0.001). These data suggest increased supply of cholesterol to the liver. We found that hepatic proprotein convertase subtilisin/kexin type 9 (Pcsk9) expression was decreased (-28%, P<0.01) accompanied by decreased plasma PCSK9 levels (-47%, P<0.001), and increased hepatic LDL receptor protein content (+64%, P<0.01). Consistent with this, anacetrapib increased the clearance and hepatic uptake (+25%, P<0.001) of [14C]cholesteryl oleate-labeled VLDL-mimicking particles. In APOE*3-Leiden mice that do not express CETP, anacetrapib still decreased (V)LDL-C and plasma PCSK9 levels, indicating that these effects were independent of CETP inhibition. Anacetrapib reduces (V)LDL-C by two mechanisms: 1) inhibition of CETP activity, resulting in remodelled VLDL that are more susceptible to hepatic uptake and 2) a CETP-independent reduction of plasma PCSK9 levels that has the potential to increase LDL receptor mediated hepatic remnant clearance.
TNO Identifier
528177
Source
Journal of Lipid Research, 56(11), pp. 2085-2093.
Pages
2085-2093