A selective peroxisome proliferator-activated receptor δ agonist promotes reverse cholesterol transport

William R. Oliver1, Jennifer L. Shenk1, Mike R. Snaith1, CAROLINE S. RUSSELL1, Kelli D. Plunket1, Noni L. Bodkin1, Michael C. Lewis1, Deborah A. Winegar1, Marcos L. Sznaidman1, Millard H. Lambert1, H. Eric Xu1, Daniel D. Sternbach1, Steven A. Kliewer1, Barbara C. Hansen1, Timothy M. Willson1
1Metabolic Diseases Drug Discovery and Nuclear Receptor Discovery Research, GlaxoSmithKline, Research Triangle Park, NC 27709; Cardiovascular Diseases Drug Discovery, GlaxoSmithKline, Stevenage, Hertfordshire SG1 2NY, United Kingdom; and Obesity and Diabetes Research Center, University of Maryland School of Medicine, Baltimore, MD 21201

Tóm tắt

The peroxisome proliferator-activated receptors (PPARs) are dietary lipid sensors that regulate fatty acid and carbohydrate metabolism. The hypolipidemic effects of the fibrate drugs and the antidiabetic effects of the glitazone drugs in humans are due to activation of the α (NR1C1) and γ (NR1C3) subtypes, respectively. By contrast, the therapeutic potential of the δ (NR1C2) subtype is unknown, due in part to the lack of selective ligands. We have used combinatorial chemistry and structure-based drug design to develop a potent and subtype-selective PPARδ agonist, GW501516. In macrophages, fibroblasts, and intestinal cells, GW501516 increases expression of the reverse cholesterol transporter ATP-binding cassette A1 and induces apolipoprotein A1-specific cholesterol efflux. When dosed to insulin-resistant middle-aged obese rhesus monkeys, GW501516 causes a dramatic dose-dependent rise in serum high density lipoprotein cholesterol while lowering the levels of small-dense low density lipoprotein, fasting triglycerides, and fasting insulin. Our results suggest that PPARδ agonists may be effective drugs to increase reverse cholesterol transport and decrease cardiovascular disease associated with the metabolic syndrome X.

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