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Published in: Journal of Translational Medicine 1/2015

Open Access 01-12-2015 | Research

Impacts of ezetimibe on PCSK9 in rats: study on the expression in different organs and the potential mechanisms

Authors: Rui-Xia Xu, Jun Liu, Xiao-Lin Li, Sha Li, Yan Zhang, Yan-Jun Jia, Jing Sun, Jian-Jun Li

Published in: Journal of Translational Medicine | Issue 1/2015

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Abstract

Background

Previous studies including our group have indicated the effects of ezetimibe on increased plasma proprotein convertase subtilisin/kexin type 9 (PCSK9) concentration, while the rapid expression in different organs and the potential molecular mechanisms for this impact have not been carefully evaluated.

Methods

Thirty rats were randomly divided into two groups (n = 15 for each), which were orally administrated with ezetimibe (10 mg/kg/day) or normal saline. Blood samples were obtained at day 3 after orally administration, and the PCSK9 levels were determined by ELISA. We further analyzed the mRNA expression of PCSK9, low-density lipoprotein receptor (LDLR), sterol regulator element-binding protein 2 (SREBP2), and hepatocyte nuclear factor 1 alpha (HNF-1α) by real-time PCR, as well as the protein expression by western blot, in liver, intestine and kidney respectively.

Results

Ezetimibe significantly increased plasma PCSK9 levels compared with control group, while there was no significant difference between the two groups with regard to lipid profile at day 3. Moreover, ezetimibe remarkably increased the expression of PCSK9, LDLR, SREBP2 and HNF-1α in liver. Enhanced expression of PCSK9, LDLR and SREBP2 protein were found in intestine and kidney, while no changes in the expression of HNF-1α were observed in intestine and kidney of rats with ezetimibe treatment.

Conclusions

The data demonstrated that ezetimibe increased PCSK9 expression through the SREBP2 and HNF-1α pathways in different organs, subsequently resulting in elevated plasma PCSK9 levels prior to the alterations of lipid profile in rats.
Literature
1.
go back to reference Seidah NG, Prat A. The biology and therapeutic targeting of the proprotein convertases. Nat Rev Drug Discov. 2012;11:367–83.CrossRefPubMed Seidah NG, Prat A. The biology and therapeutic targeting of the proprotein convertases. Nat Rev Drug Discov. 2012;11:367–83.CrossRefPubMed
2.
go back to reference Schmidt RJ, Zhang Y, Zhao Y, Qian YW, Wang H, Lin A, et al. A novel splicing variant of proprotein convertase subtilisin/kexin type 9. DNA Cell Biol. 2008;27:183–9.CrossRefPubMed Schmidt RJ, Zhang Y, Zhao Y, Qian YW, Wang H, Lin A, et al. A novel splicing variant of proprotein convertase subtilisin/kexin type 9. DNA Cell Biol. 2008;27:183–9.CrossRefPubMed
3.
go back to reference Seidah NG, Benjannet S, Wickham L, Marcinkiewicz J, Jasmin SB, Stifani S, et al. The secretory proprotein convertase neural apoptosis-regulated convertase 1 (NARC-1): liver regeneration and neuronal differentiation. Proc Natl Acad Sci U S A. 2003;100:928–33.CrossRefPubMedCentralPubMed Seidah NG, Benjannet S, Wickham L, Marcinkiewicz J, Jasmin SB, Stifani S, et al. The secretory proprotein convertase neural apoptosis-regulated convertase 1 (NARC-1): liver regeneration and neuronal differentiation. Proc Natl Acad Sci U S A. 2003;100:928–33.CrossRefPubMedCentralPubMed
4.
go back to reference Wu Q, Tang ZH, Peng J, Liao L, Pan LH, Wu CY, et al. The dual behavior of PCSK9 in the regulation of apoptosis is crucial in Alzheimer’s disease progression (Review). Biomed Rep. 2014;2:167–71.PubMedCentralPubMed Wu Q, Tang ZH, Peng J, Liao L, Pan LH, Wu CY, et al. The dual behavior of PCSK9 in the regulation of apoptosis is crucial in Alzheimer’s disease progression (Review). Biomed Rep. 2014;2:167–71.PubMedCentralPubMed
6.
go back to reference Seidah NG. PCSK9 as a therapeutic target of dyslipidemia. Expert Opin Ther Targets. 2009;13:19–28.CrossRefPubMed Seidah NG. PCSK9 as a therapeutic target of dyslipidemia. Expert Opin Ther Targets. 2009;13:19–28.CrossRefPubMed
7.
go back to reference Welder G, Zineh I, Pacanowski MA, Troutt JS, Cao G, Konrad RJ. High-dose atorvastatin causes a rapid sustained increase in human serum PCSK9 and disrupts its correlation with LDL cholesterol. J Lipid Res. 2010;51:2714–21.CrossRefPubMedCentralPubMed Welder G, Zineh I, Pacanowski MA, Troutt JS, Cao G, Konrad RJ. High-dose atorvastatin causes a rapid sustained increase in human serum PCSK9 and disrupts its correlation with LDL cholesterol. J Lipid Res. 2010;51:2714–21.CrossRefPubMedCentralPubMed
8.
go back to reference Awan Z, Seidah NG, MacFadyen JG, Benjannet S, Chasman DI, Ridker PM, et al. Rosuvastatin, proprotein convertase subtilisin/kexin type 9 concentrations, and LDL cholesterol response: the JUPITER trial. Clin Chem. 2012;58:183–9.CrossRefPubMed Awan Z, Seidah NG, MacFadyen JG, Benjannet S, Chasman DI, Ridker PM, et al. Rosuvastatin, proprotein convertase subtilisin/kexin type 9 concentrations, and LDL cholesterol response: the JUPITER trial. Clin Chem. 2012;58:183–9.CrossRefPubMed
9.
go back to reference Raal F, Panz V, Immelman A, Pilcher G. Elevated PCSK9 levels in untreated patients with heterozygous or homozygous familial hypercholesterolemia and the response to high-dose statin therapy. J Am Heart Assoc. 2013;2:e000028.CrossRefPubMedCentralPubMed Raal F, Panz V, Immelman A, Pilcher G. Elevated PCSK9 levels in untreated patients with heterozygous or homozygous familial hypercholesterolemia and the response to high-dose statin therapy. J Am Heart Assoc. 2013;2:e000028.CrossRefPubMedCentralPubMed
10.
go back to reference Dubuc G, Chamberland A, Wassef H, Davignon J, Seidah NG, Bernier L, et al. Statins upregulate PCSK9, the gene encoding the proprotein convertase neural apoptosis-regulated convertase-1 implicated in familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2004;24:1454–9.CrossRefPubMed Dubuc G, Chamberland A, Wassef H, Davignon J, Seidah NG, Bernier L, et al. Statins upregulate PCSK9, the gene encoding the proprotein convertase neural apoptosis-regulated convertase-1 implicated in familial hypercholesterolemia. Arterioscler Thromb Vasc Biol. 2004;24:1454–9.CrossRefPubMed
11.
go back to reference Taylor AJ, Villines TC, Stanek EJ, Devine PJ, Griffen L, Miller M, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med. 2009;361:2113–22.CrossRefPubMed Taylor AJ, Villines TC, Stanek EJ, Devine PJ, Griffen L, Miller M, et al. Extended-release niacin or ezetimibe and carotid intima-media thickness. N Engl J Med. 2009;361:2113–22.CrossRefPubMed
12.
go back to reference Zhang Y, Liu J, Li S, Xu RX, Sun J, Li JJ. Impact of currently prescribed lipid-lowering drugs on plasma PCSK9 concentration: single or in combination study in rats. Lipids Health Dis. 2014;13:35.CrossRefPubMedCentralPubMed Zhang Y, Liu J, Li S, Xu RX, Sun J, Li JJ. Impact of currently prescribed lipid-lowering drugs on plasma PCSK9 concentration: single or in combination study in rats. Lipids Health Dis. 2014;13:35.CrossRefPubMedCentralPubMed
13.
go back to reference Xu R, Lin F, Zhang S, Chen X, Hu S, Zheng Z. Signal pathways involved in reverse remodeling of the hypertrophic rat heart after pressure unloading. Int J Cardiol. 2010;143:414–23.CrossRefPubMed Xu R, Lin F, Zhang S, Chen X, Hu S, Zheng Z. Signal pathways involved in reverse remodeling of the hypertrophic rat heart after pressure unloading. Int J Cardiol. 2010;143:414–23.CrossRefPubMed
14.
go back to reference Chen ZY, Liu SN, Li CN, Sun SJ, Liu Q, Lei L, et al. Atorvastatin helps preserve pancreatic beta cell function in obese C57BL/6 J mice and the effect is related to increased pancreas proliferation and amelioration of endoplasmic-reticulum stress. Lipids Health Dis. 2014;13:98.CrossRefPubMedCentralPubMed Chen ZY, Liu SN, Li CN, Sun SJ, Liu Q, Lei L, et al. Atorvastatin helps preserve pancreatic beta cell function in obese C57BL/6 J mice and the effect is related to increased pancreas proliferation and amelioration of endoplasmic-reticulum stress. Lipids Health Dis. 2014;13:98.CrossRefPubMedCentralPubMed
16.
go back to reference Lagace TA, Curtis DE, Garuti R, McNutt MC, Park SW, Prather HB, et al. Secreted PCSK9 decreases the number of LDL receptors in hepatocytes and in livers of parabiotic mice. J Clin Invest. 2006;116:2995–3005.CrossRefPubMedCentralPubMed Lagace TA, Curtis DE, Garuti R, McNutt MC, Park SW, Prather HB, et al. Secreted PCSK9 decreases the number of LDL receptors in hepatocytes and in livers of parabiotic mice. J Clin Invest. 2006;116:2995–3005.CrossRefPubMedCentralPubMed
17.
go back to reference Mousavi SA, Berge KE, Leren TP. The unique role of proprotein convertase subtilisin/kexin 9 in cholesterol homeostasis. J Intern Med. 2009;266:507–19.CrossRefPubMed Mousavi SA, Berge KE, Leren TP. The unique role of proprotein convertase subtilisin/kexin 9 in cholesterol homeostasis. J Intern Med. 2009;266:507–19.CrossRefPubMed
18.
19.
go back to reference Gu HM, Adijiang A, Mah M, Zhang DW. Characterization of the role of EGF-A of low density lipoprotein receptor in PCSK9 binding. J Lipid Res. 2013;54:3345–57.CrossRefPubMedCentralPubMed Gu HM, Adijiang A, Mah M, Zhang DW. Characterization of the role of EGF-A of low density lipoprotein receptor in PCSK9 binding. J Lipid Res. 2013;54:3345–57.CrossRefPubMedCentralPubMed
20.
go back to reference Farnier M. PCSK9: From discovery to therapeutic applications. Arch Cardiovasc Dis. 2014;107:58–66.CrossRefPubMed Farnier M. PCSK9: From discovery to therapeutic applications. Arch Cardiovasc Dis. 2014;107:58–66.CrossRefPubMed
21.
go back to reference Careskey HE, Davis RA, Alborn WE, Troutt JS, Cao G, Konrad RJ. Atorvastatin increases human serum levels of proprotein convertase subtilisin/kexin type 9. J Lipid Res. 2008;49:394–8.CrossRefPubMed Careskey HE, Davis RA, Alborn WE, Troutt JS, Cao G, Konrad RJ. Atorvastatin increases human serum levels of proprotein convertase subtilisin/kexin type 9. J Lipid Res. 2008;49:394–8.CrossRefPubMed
22.
go back to reference Werner C, Hoffmann MM, Winkler K, Bohm M, Laufs U. Risk prediction with proprotein convertase subtilisin/kexin type 9 (PCSK9) in patients with stable coronary disease on statin treatment. Vascul Pharmacol. 2014;62:94–102.CrossRefPubMed Werner C, Hoffmann MM, Winkler K, Bohm M, Laufs U. Risk prediction with proprotein convertase subtilisin/kexin type 9 (PCSK9) in patients with stable coronary disease on statin treatment. Vascul Pharmacol. 2014;62:94–102.CrossRefPubMed
23.
go back to reference Guo YL, Liu J, Xu RX, Zhu CG, Wu NQ, Jiang LX, et al. Short-term impact of low-dose atorvastatin on serum proprotein convertase subtilisin/kexin type 9. Clin Drug Investig. 2013;33:877–83.CrossRefPubMed Guo YL, Liu J, Xu RX, Zhu CG, Wu NQ, Jiang LX, et al. Short-term impact of low-dose atorvastatin on serum proprotein convertase subtilisin/kexin type 9. Clin Drug Investig. 2013;33:877–83.CrossRefPubMed
24.
go back to reference Pisciotta L, Fasano T, Bellocchio A, Bocchi L, Sallo R, Fresa R, et al. Effect of ezetimibe coadministered with statins in genotype-confirmed heterozygous FH patients. Atherosclerosis. 2007;194:e116–22.CrossRefPubMed Pisciotta L, Fasano T, Bellocchio A, Bocchi L, Sallo R, Fresa R, et al. Effect of ezetimibe coadministered with statins in genotype-confirmed heterozygous FH patients. Atherosclerosis. 2007;194:e116–22.CrossRefPubMed
25.
go back to reference Gouni-Berthold I, Berthold HK, Gylling H, Hallikainen M, Giannakidou E, Stier S, et al. Effects of ezetimibe and/or simvastatin on LDL receptor protein expression and on LDL receptor and HMG-CoA reductase gene expression: a randomized trial in healthy men. Atherosclerosis. 2008;198:198–207.CrossRefPubMed Gouni-Berthold I, Berthold HK, Gylling H, Hallikainen M, Giannakidou E, Stier S, et al. Effects of ezetimibe and/or simvastatin on LDL receptor protein expression and on LDL receptor and HMG-CoA reductase gene expression: a randomized trial in healthy men. Atherosclerosis. 2008;198:198–207.CrossRefPubMed
26.
go back to reference Telford DE, Sutherland BG, Edwards JY, Andrews JD, Barrett PH, Huff MW. The molecular mechanisms underlying the reduction of LDL apoB-100 by ezetimibe plus simvastatin. J Lipid Res. 2007;48:699–708.CrossRefPubMed Telford DE, Sutherland BG, Edwards JY, Andrews JD, Barrett PH, Huff MW. The molecular mechanisms underlying the reduction of LDL apoB-100 by ezetimibe plus simvastatin. J Lipid Res. 2007;48:699–708.CrossRefPubMed
27.
go back to reference Davignon J, Dubuc G. Statins and ezetimibe modulate plasma proprotein convertase subtilisin kexin-9 (PCSK9) levels. Trans Am Clin Climatol Assoc. 2009;120:163–73.PubMedCentralPubMed Davignon J, Dubuc G. Statins and ezetimibe modulate plasma proprotein convertase subtilisin kexin-9 (PCSK9) levels. Trans Am Clin Climatol Assoc. 2009;120:163–73.PubMedCentralPubMed
28.
go back to reference Hentze H, Jensen KK, Chia SM, Johns DG, Shaw RJ, Davis Jr HR, et al. Inverse relationship between LDL cholesterol and PCSK9 plasma levels in dyslipidemic cynomolgus monkeys: effects of LDL lowering by ezetimibe in the absence of statins. Atherosclerosis. 2013;231:84–90.CrossRefPubMed Hentze H, Jensen KK, Chia SM, Johns DG, Shaw RJ, Davis Jr HR, et al. Inverse relationship between LDL cholesterol and PCSK9 plasma levels in dyslipidemic cynomolgus monkeys: effects of LDL lowering by ezetimibe in the absence of statins. Atherosclerosis. 2013;231:84–90.CrossRefPubMed
29.
go back to reference Rousselet E, Marcinkiewicz J, Kriz J, Zhou A, Hatten ME, Prat A, et al. PCSK9 reduces the protein levels of the LDL receptor in mouse brain during development and after ischemic stroke. J Lipid Res. 2011;52:1383–91.CrossRefPubMedCentralPubMed Rousselet E, Marcinkiewicz J, Kriz J, Zhou A, Hatten ME, Prat A, et al. PCSK9 reduces the protein levels of the LDL receptor in mouse brain during development and after ischemic stroke. J Lipid Res. 2011;52:1383–91.CrossRefPubMedCentralPubMed
30.
go back to reference Le May C, Kourimate S, Langhi C, Chetiveaux M, Jarry A, Comera C, et al. Proprotein convertase subtilisin kexin type 9 null mice are protected from postprandial triglyceridemia. Arterioscler Thromb Vasc Biol. 2009;29:684–90.CrossRefPubMed Le May C, Kourimate S, Langhi C, Chetiveaux M, Jarry A, Comera C, et al. Proprotein convertase subtilisin kexin type 9 null mice are protected from postprandial triglyceridemia. Arterioscler Thromb Vasc Biol. 2009;29:684–90.CrossRefPubMed
31.
go back to reference Luo Y, Warren L, Xia D, Jensen H, Sand T, Petras S, et al. Function and distribution of circulating human PCSK9 expressed extrahepatically in transgenic mice. J Lipid Res. 2009;50:1581–8.CrossRefPubMedCentralPubMed Luo Y, Warren L, Xia D, Jensen H, Sand T, Petras S, et al. Function and distribution of circulating human PCSK9 expressed extrahepatically in transgenic mice. J Lipid Res. 2009;50:1581–8.CrossRefPubMedCentralPubMed
32.
go back to reference Tavori H, Fan D, Blakemore JL, Yancey PG, Ding L, Linton MF, et al. Serum proprotein convertase subtilisin/kexin type 9 and cell surface low-density lipoprotein receptor: evidence for a reciprocal regulation. Circulation. 2013;127:2403–13.CrossRefPubMedCentralPubMed Tavori H, Fan D, Blakemore JL, Yancey PG, Ding L, Linton MF, et al. Serum proprotein convertase subtilisin/kexin type 9 and cell surface low-density lipoprotein receptor: evidence for a reciprocal regulation. Circulation. 2013;127:2403–13.CrossRefPubMedCentralPubMed
33.
go back to reference Turpeinen H, Raitoharju E, Oksanen A, Oksala N, Levula M, Lyytikainen LP, et al. Proprotein convertases in human atherosclerotic plaques: the overexpression of FURIN and its substrate cytokines BAFF and APRIL. Atherosclerosis. 2011;219:799–806.CrossRefPubMed Turpeinen H, Raitoharju E, Oksanen A, Oksala N, Levula M, Lyytikainen LP, et al. Proprotein convertases in human atherosclerotic plaques: the overexpression of FURIN and its substrate cytokines BAFF and APRIL. Atherosclerosis. 2011;219:799–806.CrossRefPubMed
34.
go back to reference Chen YQ, Troutt JS, Konrad RJ. PCSK9 is present in human cerebrospinal fluid and is maintained at remarkably constant concentrations throughout the course of the day. Lipids. 2014;49:445–55.CrossRefPubMed Chen YQ, Troutt JS, Konrad RJ. PCSK9 is present in human cerebrospinal fluid and is maintained at remarkably constant concentrations throughout the course of the day. Lipids. 2014;49:445–55.CrossRefPubMed
35.
go back to reference Galman C, Matasconi M, Persson L, Parini P, Angelin B, Rudling M. Age-induced hypercholesterolemia in the rat relates to reduced elimination but not increased intestinal absorption of cholesterol. Am J Physiol Endocrinol Metab. 2007;293:E737–42.CrossRefPubMed Galman C, Matasconi M, Persson L, Parini P, Angelin B, Rudling M. Age-induced hypercholesterolemia in the rat relates to reduced elimination but not increased intestinal absorption of cholesterol. Am J Physiol Endocrinol Metab. 2007;293:E737–42.CrossRefPubMed
36.
go back to reference Berthold HK, Seidah NG, Benjannet S, Gouni-Berthold I. Evidence from a randomized trial that simvastatin, but not ezetimibe, upregulates circulating PCSK9 levels. PLoS One. 2013;8:e60095.CrossRefPubMedCentralPubMed Berthold HK, Seidah NG, Benjannet S, Gouni-Berthold I. Evidence from a randomized trial that simvastatin, but not ezetimibe, upregulates circulating PCSK9 levels. PLoS One. 2013;8:e60095.CrossRefPubMedCentralPubMed
37.
go back to reference Ason B, Tep S, Davis Jr HR, Xu Y, Tetzloff G, Galinski B, et al. Improved efficacy for ezetimibe and rosuvastatin by attenuating the induction of PCSK9. J Lipid Res. 2011;52:679–87.CrossRefPubMedCentralPubMed Ason B, Tep S, Davis Jr HR, Xu Y, Tetzloff G, Galinski B, et al. Improved efficacy for ezetimibe and rosuvastatin by attenuating the induction of PCSK9. J Lipid Res. 2011;52:679–87.CrossRefPubMedCentralPubMed
38.
go back to reference Li H, Dong B, Park SW, Lee HS, Chen W, Liu J. Hepatocyte nuclear factor 1alpha plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound berberine. J Biol Chem. 2009;284:28885–95.CrossRefPubMedCentralPubMed Li H, Dong B, Park SW, Lee HS, Chen W, Liu J. Hepatocyte nuclear factor 1alpha plays a critical role in PCSK9 gene transcription and regulation by the natural hypocholesterolemic compound berberine. J Biol Chem. 2009;284:28885–95.CrossRefPubMedCentralPubMed
39.
go back to reference Repa JJ, Turley SD, Quan G, Dietschy JM. Delineation of molecular changes in intrahepatic cholesterol metabolism resulting from diminished cholesterol absorption. J Lipid Res. 2005;46:779–89.CrossRefPubMed Repa JJ, Turley SD, Quan G, Dietschy JM. Delineation of molecular changes in intrahepatic cholesterol metabolism resulting from diminished cholesterol absorption. J Lipid Res. 2005;46:779–89.CrossRefPubMed
Metadata
Title
Impacts of ezetimibe on PCSK9 in rats: study on the expression in different organs and the potential mechanisms
Authors
Rui-Xia Xu
Jun Liu
Xiao-Lin Li
Sha Li
Yan Zhang
Yan-Jun Jia
Jing Sun
Jian-Jun Li
Publication date
01-12-2015
Publisher
BioMed Central
Published in
Journal of Translational Medicine / Issue 1/2015
Electronic ISSN: 1479-5876
DOI
https://doi.org/10.1186/s12967-015-0452-x

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