Abstract
ETC-1002 (8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid) is a novel investigational drug being developed for the treatment of dyslipidemia and other cardio-metabolic risk factors. The hypolipidemic, anti-atherosclerotic, anti-obesity, and glucose-lowering properties of ETC-1002, characterized in preclinical disease models, are believed to be due to dual inhibition of sterol and fatty acid synthesis and enhanced mitochondrial long-chain fatty acid β-oxidation. However, the molecular mechanism(s) mediating these activities remained undefined. Studies described here show that ETC-1002 free acid activates AMP-activated protein kinase in a Ca(2+)/calmodulin-dependent kinase β-independent and liver kinase β 1-dependent manner, without detectable changes in adenylate energy charge. Furthermore, ETC-1002 is shown to rapidly form a CoA thioester in liver, which directly inhibits ATP-citrate lyase. These distinct molecular mechanisms are complementary in their beneficial effects on lipid and carbohydrate metabolism in vitro and in vivo. Consistent with these mechanisms, ETC-1002 treatment reduced circulating proatherogenic lipoproteins, hepatic lipids, and body weight in a hamster model of hyperlipidemia, and it reduced body weight and improved glycemic control in a mouse model of diet-induced obesity. ETC-1002 offers promise as a novel therapeutic approach to improve multiple risk factors associated with metabolic syndrome and benefit patients with cardiovascular disease.
MeSH terms
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AMP-Activated Protein Kinase Kinases
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AMP-Activated Protein Kinases / metabolism*
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ATP Citrate (pro-S)-Lyase / antagonists & inhibitors
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ATP Citrate (pro-S)-Lyase / metabolism*
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Animals
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Biomarkers / blood
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Biomarkers / metabolism
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Calcium / metabolism
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Carbohydrate Metabolism / drug effects*
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Cricetinae
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Dicarboxylic Acids / chemistry
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Dicarboxylic Acids / pharmacology*
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Dicarboxylic Acids / therapeutic use
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Diet / adverse effects
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Dyslipidemias / blood
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Dyslipidemias / drug therapy
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Dyslipidemias / metabolism
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Energy Metabolism / drug effects
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Enzyme Activation / drug effects
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Enzyme Inhibitors / chemistry
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Enzyme Inhibitors / pharmacology*
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Enzyme Inhibitors / therapeutic use
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Fatty Acids / biosynthesis
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Fatty Acids / chemistry
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Fatty Acids / pharmacology*
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Fatty Acids / therapeutic use
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Female
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Glucagon / metabolism
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Glucose / biosynthesis
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Hep G2 Cells
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Humans
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Lipid Metabolism / drug effects*
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Liver / cytology
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Liver / drug effects
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Liver / enzymology
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Liver / metabolism
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Male
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Mice
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Molecular Targeted Therapy / methods*
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Obesity / blood
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Obesity / drug therapy
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Obesity / etiology
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Obesity / metabolism
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Protein Serine-Threonine Kinases / metabolism
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Rats
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Signal Transduction / drug effects
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Sterols / biosynthesis
Substances
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Biomarkers
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Dicarboxylic Acids
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Enzyme Inhibitors
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Fatty Acids
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Sterols
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8-hydroxy-2,2,14,14-tetramethylpentadecanedioic acid
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Glucagon
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pentadecanoic acid
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ATP Citrate (pro-S)-Lyase
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Protein Serine-Threonine Kinases
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STK11 protein, human
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AMP-Activated Protein Kinase Kinases
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AMP-Activated Protein Kinases
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Glucose
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Calcium