{"id":32814,"date":"2012-11-05T21:15:31","date_gmt":"2012-11-06T02:15:31","guid":{"rendered":"http:\/\/blogs.nejm.org\/cardioexchange\/?post_type=news&#038;p=32814"},"modified":"2012-11-05T21:24:58","modified_gmt":"2012-11-06T02:24:58","slug":"early-look-new-methods-to-enhance-cholesterol-efflux","status":"publish","type":"post","link":"https:\/\/blogs.nejm.org\/cardioexchange\/2012\/11\/05\/early-look-new-methods-to-enhance-cholesterol-efflux\/","title":{"rendered":"Early Look: New Methods to Enhance Cholesterol Efflux"},"content":{"rendered":"<p>Although clinical trials of HDL-boosting CETP inhibitors have so far failed to produce positive results, many other avenues of HDL-related research remain active. Conference attendees got a glimpse of the very early phases of two intriguing lines of research in this area on Monday.<\/p>\n<p>Apoliporotein A-I is thought to be the key HDL component that removes cholesterol from cells. Almost a decade ago, a study <a title=\"Apo A1 Milano\" href=\"http:\/\/jama.jamanetwork.com\/article.aspx?articleid=197579\" target=\"_blank\">demonstrating regression of atherosclerosis with apo A-I Milano<\/a> caused tremendous excitement, but the recombinant product has not yet undergone further research or commercial development. A somewhat similar approach is now being developed by by\u00a0CSL\u00a0Limited with a novel formulation of human apo A-I, known as CSL112. At the AHA, <a title=\"Gille_PR\" href=\"http:\/\/newsroom.heart.org\/pr\/aha\/infusing-good-cholesterol-protein-239561.aspx\" target=\"_blank\">Andreas Gille and colleagues reported<\/a> giving CSL112 to healthy volunteers and observing dramatic increases in the ability of the HDL in their blood plasma to remove cholesterol from cells.<\/p>\n<p>Gille reported that the increase in cholesterol efflux capacity was higher and occurred faster than any previous therapy, more than doubling within two hours, as opposed to a 2.9% increase after 4 weeks with niacin or 6.8% after 24 months with dalcetrapib. &#8220;CSL112 may offer a novel means to rapidly remove cholesterol from plaque following a heart attack,&#8221; said Gille. To date, two phase 1 studies have demonstrated a favorable safety profile, he reported. A phase 2 study of CSL112 in patients with an acute coronary syndrome is planned.<\/p>\n<p>An even more unusual approach is being explored by Alan Fogelman and his team, who have genetically engineered a tomato to produce a small peptide, 6F, that mimics the action of apo A-I. They then fed the tomatoes to mice with high LDL levels. After consuming the tomatoes along with a high-fat and high-calorie diet, a number of signs suggested a beneficial effect, including significantly lower levels of inflammation, higher levels of the antioxidant paraoxonase, higher HDL levels, and less atherosclerotic plaque.<\/p>\n<p>\u201cTo our knowledge this is the first example of a drug with these properties that has been produced in an edible plant and is biologically active when fed without any isolation or purification of the drug,\u201d <a title=\"FogelmanPR\" href=\"http:\/\/newsroom.heart.org\/pr\/aha\/genetically-engineered-tomatoes-239560.aspx\" target=\"_blank\">Fogelman said in an AHA press release<\/a>.<\/p>\n<p>For related CardioExchange content, go to our\u00a0<a title=\"AHA2012Headquarterspage\" href=\"http:\/\/blogs.nejm.org\/cardioexchange\/news\/aha-2012-headquarters\/\" target=\"_blank\">AHA 2012 Headquarters\u00a0page<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Although clinical trials of HDL-boosting CETP inhibitors have so far failed to produce positive results, many other avenues of HDL-related research remain active. Conference attendees got a glimpse of the very early phases of two intriguing lines of research in this area on Monday. Apoliporotein A-I is thought to be the key HDL component that [&hellip;]<\/p>\n","protected":false},"author":196,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[7],"tags":[210,1551,209],"class_list":["post-32814","post","type-post","status-publish","format-standard","hentry","category-prevention","tag-cholesterol","tag-efflux","tag-hdl"],"_links":{"self":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/32814","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/users\/196"}],"replies":[{"embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/comments?post=32814"}],"version-history":[{"count":0,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/posts\/32814\/revisions"}],"wp:attachment":[{"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/media?parent=32814"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/categories?post=32814"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/blogs.nejm.org\/cardioexchange\/wp-json\/wp\/v2\/tags?post=32814"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}