BACKGROUND: High-density lipoprotein plays a key role in reverse cholesterol transport. In addition, high-density lipoprotein particles may be cardioprotective and reduce infarct size in the setting of myocardial injury. Lecithin-cholesterol acyltransferase is a rate-limiting enzyme in reverse cholesterol transport. MEDI6012 is a recombinant human lecithin-cholesterol acyltransferase that increases high-density lipoprotein cholesterol. Administration of lecithin-cholesterol acyltransferase has the potential to reduce infarct size and regress coronary plaque in acute ST-segment-elevation myocardial infarction. METHODS: REAL-TIMI 63B (A Randomized, Placebo‑controlled Phase 2b Study to Evaluate the Safety and Efficacy of MEDI6012 in Acute ST Elevation Myocardial Infarction) was a phase 2B multinational, placebo-controlled, randomized trial. Patients with ST-segment-elevation myocardial infarction within 6 hours of symptom onset and planned for percutaneous intervention were randomly assigned 2:1 to MEDI6012 (2- or 6-dose regimen) or placebo and followed for 12 weeks. The primary outcome was infarct size as a percentage of left ventricular mass by cardiac MRI at 10 to 12 weeks, with the primary analysis in patients with TIMI Flow Grade 0 to 1 before percutaneous intervention who received at least 2 doses of MEDI6012. The secondary outcome was change in noncalcified plaque volume on coronary computed tomographic angiography from baseline to 10 to 12 weeks with the primary analysis in patients who received all 6 doses of MEDI6012. RESULTS: A total of 593 patients were randomly assigned. Patients were a median of 62 years old, 77.9% male, and 95.8% statin naive. Median time from symptom onset to randomization was 146 (interquartile range [IQR], 103-221) minutes and from hospitalization to randomization was 12.7 (IQR, 6.6-24.0) minutes, and the first dose of drug was administered a median of 8 (IQR, 3-13) minutes before percutaneous intervention. The index myocardial infarction was anterior in 69.6% and TIMI Flow Grade 0 to 1 in 65.1% of patients. At 12 weeks, infarct size did not differ between treatment groups (MEDI6012: 9.71%, IQR 4.79-16.38; placebo: 10.48%, [IQR, 4.92-16.61], 1-sided P=0.79. There was also no difference in noncalcified plaque volume (geometric mean ratio, 0.96 [95% CI, NA-1.10], 1-sided P=0.30). There was no significant difference in treatment emergent serious adverse events. CONCLUSIONS: Administration of MEDI6012 in patients with acute ST-segment-elevation myocardial infarction did not result in a significant reduction in infarct size or noncalcified plaque volume at 12 weeks. MEDI6012 was well tolerated with no excess in overall serious adverse events. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT03578809.

• Klíčová slova
• HDL, ST elevation myocardial infarction, acyltransferases, cholesterol ester transfer proteins, lipoproteins,
• MeSH
• cholesterol MeSH
• cholesterolacyltransferasa terapeutické užití   MeSH
• infarkt myokardu přední stěny * MeSH
• infarkt myokardu s elevacemi ST úseků * diagnostické zobrazování   farmakoterapie   MeSH
• lecitincholesterolacyltransferasa * terapeutické užití   MeSH
• lecitiny terapeutické užití   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipoproteiny HDL terapeutické užití   MeSH
• statiny * terapeutické užití   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• klinické zkoušky, fáze II MeSH
• práce podpořená grantem MeSH
• randomizované kontrolované studie MeSH
• Názvy látek
• cholesterol MeSH
• cholesterolacyltransferasa MeSH
• lecitincholesterolacyltransferasa * MeSH
• lecitiny MeSH
• lipoproteiny HDL MeSH
• statiny * MeSH

BACKGROUND: The etiopathogenesis of abdominal aortic aneurysm (AAA) is still unclarified, but vascular inflammation and matrix metalloproteases activation have a recognized role in AAA development and progression. Circulating lipoproteins are involved in tissue inflammation and repair, particularly through the regulation of intracellular cholesterol, whose excess is associated to cell damage and proinflammatory activation. We analyzed lipoprotein metabolism and function in AAA and in control vasculopathic patients, to highlight possible non-atherosclerosis-related, specific abnormalities. METHODS: We measured fluorometrically serum esterified/total cholesterol ratio, as an index of lecithin-cholesterol acyltransferase (LCAT) activity, and cholesteryl ester transfer protein (CETP) activity in patients referred to vascular surgery either for AAA (n=30) or stenotic aortic/peripheral atherosclerosis (n=21) having similar burden of cardiovascular risk factors and disease. We measured high-density lipoprotein (HDL)-cholesterol efflux capacity (CEC), through the ATP-binding cassette G1 (ABCG1) and A1 (ABCA1) pathways and serum cell cholesterol loading capacity (CLC), by radioisotopic and fluorimetric methods, respectively. RESULTS: We found higher LCAT (+23%; p < 0.0001) and CETP (+49%; p < 0.0001) activity in AAA sera. HDL ABCG1-CEC was lower (-16%; p < 0.001) and ABCA1-CEC was higher (+31.7%; p < 0.0001) in AAA. Stratification suggests that smoking may partly contribute to these modifications. CEC and CETP activity correlated with CLC only in AAA. CONCLUSIONS: We demonstrated that compared to patients with stenotic atherosclerosis, patients with AAA had altered HDL metabolism and functions involved in their anti-inflammatory and tissue repair activity, particularly through the ABCG1-related intracellular signaling. Clarifying the relevance of this mechanism for AAA evolution might help in developing new diagnostic parameters and therapeutic targets for the early management of this condition.

• Klíčová slova
• ABCA1, ABCG1, arterial aneurysm, cholesterol efflux, cholesteryl ester transfer protein, inflammation, lecithin cholesterol acyltransferase, vascular biology,
• MeSH
• adenosintrifosfát MeSH
• aneurysma břišní aorty * MeSH
• antiflogistika MeSH
• ateroskleróza * MeSH
• cholesterol metabolismus   MeSH
• cholesterolacyltransferasa metabolismus   MeSH
• HDL-cholesterol MeSH
• homeostáza MeSH
• lecitiny MeSH
• lidé MeSH
• lipoproteiny metabolismus   MeSH
• metaloproteasy metabolismus   MeSH
• transportní proteiny pro estery cholesterolu MeSH
• zánět metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Názvy látek
• adenosintrifosfát MeSH
• antiflogistika MeSH
• cholesterol MeSH
• cholesterolacyltransferasa MeSH
• HDL-cholesterol MeSH
• lecitiny MeSH
• lipoproteiny MeSH
• metaloproteasy MeSH
• transportní proteiny pro estery cholesterolu MeSH

High levels of fructose induce hypertriglyceridemia, characterized by excessive levels of triglyceride-rich lipoproteins such as very low-density lipoprotein (VLDL); however, the underlying mechanisms are poorly understood. The aim of this short communication was to examine hepatic changes in the expression of genes related to cholesterol metabolism in rats with hypertriglyceridemia induced by high-fructose or high-glucose diets. Rats were fed a 65 % (w/w) glucose diet or a 65 % (w/w) fructose diet for 12 days. Serum levels of triglycerides, total cholesterol, and VLDL+LDL-cholesterol, hepatic levels of triglycerides and cholesterol, and ACAT2 expression at the gene and protein levels were significantly higher in the fructose diet group compared to the glucose diet group. The hepatic levels of Abcg5/8 were lower in the fructose group than in the glucose group. Serum high-density lipoprotein (HDL)-cholesterol and hepatic expression levels of Hmgcr, Ldlr, Acat1, Mttp, Apob, and Cyp7a1 did not differ significantly between groups. These findings suggest that high-fructose diet-induced hypertriglyceridemia is associated with increased hepatic ACAT2 expression.

• MeSH
• cholesterolacyltransferasa biosyntéza   genetika   MeSH
• exprese genu MeSH
• fruktosa aplikace a dávkování   škodlivé účinky   MeSH
• hypertriglyceridemie chemicky indukované   genetika   metabolismus   MeSH
• játra účinky léků   metabolismus   MeSH
• krysa rodu Rattus MeSH
• potkani Wistar MeSH
• sterol-O-acyltransferasa 2 MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• cholesterolacyltransferasa MeSH
• fruktosa MeSH

INTRODUCTION: The aim of study was to evaluate impact of long-term dietary cholesterol overload on the cholesterol homeostasis and liver regeneration. MATERIAL AND METHODS: Serum lipid parameters, 14C-cholesterol incorporation, liver DNA synthesis and protein expression was determined in partially hepatectomized (PH) rats fed with a standard (SLD) or hypercholesterolemic (CHOL) diet. RESULTS: 29-day intake of CHOL diet before PH produced increase in serum total cholesterol, LDL lipoprotein, and triglyceride concentration. PH provoked decrease in serum total cholesterol and triglyceride concentration in both groups. PH was associated with increase in serum ALT activity more pronounced in CHOL animals. Hepatic DNA synthesis was increased after PH in both groups, but lower in CHOL. Hypercholesterolemic diet reduced the absorption of radiolabelled cholesterol in intestine and then activity in blood and liver. The 14C-cholesterol hepatic activities tend to increase after PH in both groups. CHOL diet produced up-regulation of Acyl-CoA:cholesterol acyltransferase-2 protein expression. PH was associated with increase of LDL receptor and Acyl-CoA:cholesterol acyltransferase-2 protein expression in both dietary groups. DISCUSSION: Liver regeneration after PH is negatively influenced by CHOL diet. The increased uptake of cholesterol in the liver after PH associated with up-regulation of LDL receptor protein expression suggests preferential use of extrahepatic cholesterol by the liver.

• Klíčová slova
• ACAT-2, LDL receptor, cholesterol, liver, partial hepatectomy, rat,
• MeSH
• cholesterol dietní farmakologie   MeSH
• cholesterolacyltransferasa účinky léků   metabolismus   MeSH
• DNA účinky léků   metabolismus   MeSH
• hepatektomie MeSH
• játra účinky léků   metabolismus   patologie   MeSH
• krysa rodu Rattus MeSH
• lipoproteiny LDL účinky léků   metabolismus   MeSH
• potkani Wistar MeSH
• radioizotopy uhlíku MeSH
• regenerace jater účinky léků   MeSH
• sterol-O-acyltransferasa 2 MeSH
• triglyceridy metabolismus   MeSH
• zvířata MeSH
• Check Tag
• krysa rodu Rattus MeSH
• mužské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• Carbon-14 MeSH Prohlížeč
• cholesterol dietní MeSH
• cholesterolacyltransferasa MeSH
• DNA MeSH
• lipoproteiny LDL MeSH
• radioizotopy uhlíku MeSH
• triglyceridy MeSH

• MeSH
• acyltransferasy metabolismus   MeSH
• cholesterol metabolismus   MeSH
• cholesterolacyltransferasa metabolismus   MeSH
• extrahepatální cholestáza metabolismus   MeSH
• fosfatidylcholiny metabolismus   MeSH
• lidé MeSH
• lipoprotein-X metabolismus   MeSH
• Check Tag
• lidé MeSH
• Publikační typ
• anglický abstrakt MeSH
• časopisecké články MeSH
• Názvy látek
• acyltransferasy MeSH
• cholesterol MeSH
• cholesterolacyltransferasa MeSH
• fosfatidylcholiny MeSH
• lipoprotein-X MeSH