RVX-208, an inducer of ApoA-I in humans, is a BET bromodomain antagonist.

• Main Authors: Kevin G McLure, Emily M Gesner, Laura Tsujikawa, Olesya A Kharenko, Sarah Attwell, Eric Campeau, Sylwia Wasiak, Adam Stein, Andre White, Eric Fontano, Robert K Suto, Norman C W Wong, Gregory S Wagner, Henrik C Hansen, Peter R Young
• Format: Article
• Language: English
• Published: Public Library of Science (PLoS) 2013-01-01
• Series: PLoS ONE
• Online Access: https://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24391744/pdf/?tool=EBI

Increased synthesis of Apolipoprotein A-I (ApoA-I) and HDL is believed to provide a new approach to treating atherosclerosis through the stimulation of reverse cholesterol transport. RVX-208 increases the production of ApoA-I in hepatocytes in vitro, and in vivo in monkeys and humans, which results in increased HDL-C, but the molecular target was not previously reported. Using binding assays and X-ray crystallography, we now show that RVX-208 selectively binds to bromodomains of the BET (Bromodomain and Extra Terminal) family, competing for a site bound by the endogenous ligand, acetylated lysine, and that this accounts for its pharmacological activity. siRNA experiments further suggest that induction of ApoA-I mRNA is mediated by BET family member BRD4. These data indicate that RVX-208 increases ApoA-I production through an epigenetic mechanism and suggests that BET inhibition may be a promising new approach to the treatment of atherosclerosis.