The HDL mimetic CER-001 remodels plasma lipoproteins and reduces kidney lipid deposits in inherited lecithin:cholesterol acyltransferase deficiency

J Intern Med. 2022 Mar;291(3):364-370. doi: 10.1111/joim.13404. Epub 2021 Nov 11.

Abstract

Background: Kidney failure is the major cause of morbidity and mortality in familial lecithin:cholesterol acyltransferase deficiency (FLD), a rare inherited lipid disorder with no cure. Lipoprotein X (LpX), an abnormal lipoprotein, is primarily accountable for nephrotoxicity.

Methods: CER-001 was tested in an FLD patient with dramatic kidney disease for 12 weeks.

Results: Infusions of CER-001 normalized the lipoprotein profile, with a disappearance of the abnormal LpX in favour of normal-sized LDL. The worsening of kidney function was slowed by the treatment, and kidney biopsy showed a slight reduction of lipid deposits and a stabilization of the disease. In vitro experiments demonstrate that CER-001 progressively reverts lipid accumulation in podocytes by a dual effect: remodelling plasma lipoproteins and removing LpX-induced lipid deposit.

Conclusion: This study demonstrates that CER-001 may represent a therapeutic option in FLD patients. It also has the potential to be beneficial in other renal diseases characterized by kidney lipid deposits.

Keywords: CER-001; HDL mimetic; chronic kidney disease; familial LCAT deficiency; lipids.

MeSH terms

  • Apolipoprotein A-I / therapeutic use
  • Humans
  • Kidney / pathology
  • Lecithin Cholesterol Acyltransferase Deficiency* / drug therapy
  • Lecithin Cholesterol Acyltransferase Deficiency* / pathology
  • Lipoproteins
  • Phosphatidylcholine-Sterol O-Acyltransferase / pharmacology
  • Phosphatidylcholine-Sterol O-Acyltransferase / therapeutic use
  • Phospholipids
  • Recombinant Proteins

Substances

  • Apolipoprotein A-I
  • CER-001
  • Lipoproteins
  • Phospholipids
  • Recombinant Proteins
  • Phosphatidylcholine-Sterol O-Acyltransferase