It gives rise in order to antibodies that could prevent disease, but it’ s less than a vaccine. It qualifies as an immunotherapy because it goals one of the body’ s own proteins, not a protein of a pathogen. The “ it” in this case is AT04A, the peptide-based formulation that induces an immune response towards a protein that interferes with cholesterol clearance.

According to a recent study, AT04A lowered cholesterol in a computer mouse model of atherosclerosis. This result, detailed June 19 within the European Heart Journal , is an stimulating sign that AT04A may also perform well in humans. The Phase I study is, in fact , currently under method. If this study establishes that AT04A is both energetic and safe, it will encourage further evaluations, which may culminate within the development of effective treatments to prevent cardiovascular disease.

The particular mouse study (“ The AT04A Vaccine against Proprotein Convertase Subtilisin/Kexin Type 9 Reduces Total Cholesterol, Vascular Inflammation, and Atherosclerosis in APOE*3Leiden. CETP Mice” ) is the first to show that it is possible to immunize genetically modified mice with a molecule that causes the body to produce antibodies against an enzyme called PCSK9 (proprotein covertase subtilisin/kexin type 9), which plays a role in preventing the clearance associated with low-density lipoprotein cholesterol (“bad” cholesterol) from the blood.

The AT04A vaccine induced high and chronic antibody levels against PCSK9, causing a significant reduction in lcd total cholesterol and bad cholesterol compared with controls.

“ Plasma inflammatory markers such as serum amyloid A (SAA), macrophage inflammatory protein-1β (MIP-1β /CCL4), macrophage-derived chemokine (MDC/CCL22), cytokine stem cell factor (SCF), plus vascular endothelial growth factor A (VEGF-A) were considerably diminished in AT04A-treated mice, ” reported the writers of the European Heart Journal article. “ As a consequence, treatment with the AT04A vaccine led to a decrease in atherosclerotic lesion area… and aortic swelling as well as in more lesion-free aortic segments. ”

When the AT04A formulation was injected under the skin within mice that have been fed fatty, Western-style food, it decreased the total amount of cholesterol by 53%, shrank atherosclerotic harm to blood vessels by 64%, and reduced biological markers associated with blood vessel inflammation by 21% to 28%, in comparison to unvaccinated mice. Furthermore, the induced antibodies remained useful over the whole study period, and concentrations were nevertheless high at the end of the study.

“The reduction in overall cholesterol levels was significantly correlated with induced antibody focus, proving that induced antibodies caused the reduction in bad cholesterol and also are ultimately responsible for the reduction of atherosclerosis development, ” noted Gü nther Staffler, Ph. Deb., chief technology officer at AFFiRis (the company that will developed AT04A) and one of the authors of the study. “ As antibody concentrations remained high at the end of the study, it could be assumed they would continue to reduce cholesterol levels for some time later on, resulting in a long-lasting effect, as has been shown in previous research.

“If these findings translate successfully directly into humans, this could mean that, as the induced antibodies persist for years after a vaccination, we could develop a long-lasting therapy that, following the first vaccination, just needs an annual booster. This would lead to an effective and more convenient treatment for patients, as well as increased patient compliance. ”

At present, drugs like statins can be used to lower low-density lipoprotein cholesterol (LDL-C), however they have to be taken on a daily basis and, although they are generally well tolerated, they can cause adverse side effects in some people. The most lately approved cholesterol-lowering compounds are monoclonal antibodies targeting PCSK9, which are highly effective, but their effect is short-lived, resulting in regular reapplication and high costs.

PCSK9, nevertheless , may be targeted via an alternative approach, the one evaluated in the present study. The enzyme PCSK9 is made in the liver also it locks on to LDL-C receptors, reducing the ability of these receptors to get rid of LDL-C from the blood. When injected, AT04A leads to the body to produce antibodies that block the function associated with PCSK9, so that the activity of the LDL-C receptors is improved.

“The way that AT04A is given is comparable to a vaccine, ” explained Dr . Staffler. “However, the difference between a conventional vaccine and our approach is the fact that a vaccine induces antibodies that are specific to microbial or viral proteins that are foreign to the body— pathogens— whereas AT04A induces antibodies against a target proteins that is produced by the body— endogenous proteins. This it is definitely an immunotherapeutic approach rather than a vaccine approach. ”

In 2015, a Phase I clinical research started at the department of clinical pharmacology, Medical College of Vienna, Austria, studying AT04A and another particle, AT06A, in 72 healthy people to assess its security and activity. The study is expected to complete at the end of this season.

In an accompanying editorial (“Vaccination to Prevent Atherosclerotic Cardiovascular Disease”) in the European Heart Record , Prof. Ulrich Laufs, of the University of Leipzig, Germany, and Prof. Brian Ference, of the University associated with Bristol, U. K., and the Wayne State University College of Medicine, Detroit, MI, commented as follows: “It seems promising to further evaluate long-term LDL-C lowering by vaccination against PCSK9 for the prevention of atherosclerotic events. inch However , they added that “safety, the response within humans and the very important but unknown long-term immune results need to be very carefully addressed during the course of clinical development. ”

In particular, reductions in total cholesterol via statins as well as other drugs are associated with an increase in new-onset diabetes. “Therefore, ” the editorial continued, “ one potential security concern for long-term lowering of LDL-C with a shot directed against PCSK9 is the potential for an increased risk associated with new-onset diabetes. In the short term, the LDL-C-lowering effect of statins plus PCS9 inhibitors appears to far outweigh the risks of new-onset diabetes. ”