Back to Search Start Over

Effects of PCSK9 inhibitors on HDL cholesterol efflux and serum cholesterol loading capacity in familial hypercholesterolemia subjects: a multi-lipid-center real-world evaluation

Authors :
Palumbo, Marcella
Giammanco, Antonina
Purrello, Francesco
Pavanello, Chiara
Mombelli, Giuliana
Di Pino, Antonino
Piro, Salvatore
Cefalu', Angelo Baldassare
Calabresi, Laura
Averna, Maurizio
Bernini, Franco
Zimetti, Francesca
Adorni, Maria Pia
Scicali, Roberto
Palumbo, Marcella
Giammanco, Antonina
Purrello, Francesco
Pavanello, Chiara
Mombelli, Giuliana
Di Pino, Antonino
Piro, Salvatore
Cefalu', Angelo Baldassare
Calabresi, Laura
Averna, Maurizio
Bernini, Franco
Zimetti, Francesca
Adorni, Maria Pia
Scicali, Roberto
Source :
Frontiers in molecular biosciences. 9
Publication Year :
2022

Abstract

Proprotein convertase subtilisin/kexin type 9 (PCSK9), beyond regulating LDL cholesterol (LDL-c) plasma levels, exerts several pleiotropic effects by modulating lipid metabolism in extrahepatic cells such as macrophages. Macrophage cholesterol homeostasis depends on serum lipoprotein functions, including the HDL capacity to promote cell cholesterol efflux (CEC) and the serum capacity to promote cell cholesterol loading (CLC). The aim of this observational study was to investigate the effect of PCSK9 inhibitors (PCSK9-i) treatment on HDL-CEC and serum CLC in patients with familial hypercholesterolemia (FH). 31 genetically confirmed FH patients were recruited. Blood was collected and serum isolated at baseline and after 6 months of PCSK9-i treatment. HDL-CEC was evaluated through the main pathways with a radioisotopic cell-based assay. Serum CLC was assessed fluorimetrically in human THP-1 monocyte-derived macrophages. After treatment with PCSK9-i, total cholesterol and LDL-c significantly decreased (−41.6%, p < 0.0001 and −56.7%, p < 0.0001, respectively). Total HDL-CEC was not different between patients before and after treatment. Conversely, despite no changes in HDL-c levels between the groups, ABCG1 HDL-CEC significantly increased after treatment (+22.2%, p < 0.0001) as well as HDL-CEC by aqueous diffusion (+7.8%, p = 0.0008). Only a trend towards reduction of ABCA1 HDL-CEC was observed after treatment. PCSK9-i significantly decreased serum CLC (−6.6%, p = 0.0272). This effect was only partly related to the reduction of LDL-c levels. In conclusion, PCSK9-i treatment significantly increased HDL-CEC through ABCG1 and aqueous diffusion pathways and reduced the serum CLC in FH patients. The favorable effect of PCSK9-i on functional lipid profile could contribute to the cardiovascular benefit of these drugs in FH patients.

Details

ISSN :
2296889X
Volume :
9
Database :
OpenAIRE
Journal :
Frontiers in molecular biosciences
Accession number :
edsair.doi.dedup.....f1a302e77c07973cd35f12e6b648c2e4