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Curr Opin Endocrinol Diabetes Obes. 2010 Apr;17(2):171-6. doi: 10.1097/MED.0b013e3283373cb5.

The promise of apolipoprotein A-I mimetics.

Author information

1
Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, Diabetes Research Institute, Miller School of Medicine, University of Miami, Miami, Florida 33136, USA. amendez2@med.miami.edu

Abstract

PURPOSE OF REVIEW:

Synthetic high-density lipoprotein (HDL) and apolipoprotein (apo) A-I mimetic peptides emulate many of the atheroprotective biological functions attributed to HDL and can modify atherosclerotic disease processes. Administration of these agents as HDL replacement or modifying therapy has tremendous potential of providing new treatments for cardiovascular disease. Progress in the understanding of these agents is discussed in this review.

RECENT FINDINGS:

Prospective, observational, and interventional studies have convincingly demonstrated that elevated serum levels of high-density lipoprotein-cholesterol (HDL-C) are associated with reduced risk for coronary heart disease (CHD). Although traditional pharmacological agents have shown modest utility in raising HDL levels and reducing CHD risk, use of HDL and apo A-I mimetics provides novel therapies to not only increase HDL levels, but to also influence HDL functionality. Evidence developed over the last several years has identified a number of pathways affected by synthetic HDL and apoA-I mimetic peptides, including enhancing reverse cholesterol transport and reducing oxidation and inflammation that directly influence the progression and regression of atherosclerotic disease.

SUMMARY:

Clinical trials of relatively short-term synthetic HDL infusion into patients with CHD demonstrate beneficial effects. Use of apo A-I mimetic peptides could potentially overcome some of the limitations associated with use of the intact apo. Studies to establish the most efficacious peptides, optimal dosing regimens, and routes of administration are needed. Use of apo A-I mimetic peptides shows great promise as a therapeutic modality for HDL replacement and enhancing HDL function in treatment of patients with CHD.

PMID:
20125002
DOI:
10.1097/MED.0b013e3283373cb5
[Indexed for MEDLINE]

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