title: Azalanstat (RS-21607), a lanosterol 14 alpha-demethylase inhibitor with cholesterol-lowering activity.
abstract: Agents that inhibit hepatic cholesterol biosynthesis reduce circulating cholesterol levels in experimental animals and humans, and may be of pharmacological importance in the prevention of atherosclerosis. Azalanstat (RS-21607), a synthetic imidazole, has been shown to inhibit cholesterol synthesis in HepG2 cells, human fibroblasts, hamster hepatocytes and hamster liver, by inhibiting the cytochrome P450 enzyme lanosterol 14 alpha-demethylase. When administered orally to hamsters fed regular chow, RS-21607 (50 mg/kg/day) lowered serum cholesterol in a dose-dependent manner (ED50 = 62 mg/kg) in a period of 1 week. It preferentially lowered low density lipoprotein (LDL) cholesterol and apo B relative to high density lipoprotein (HDL) cholesterol and apo A-1. It also lowered plasma cholesterol levels in hamsters fed a high saturated fat and cholesterol diet. RS-21607 inhibited hepatic microsomal hydroxymethylglutaryl-CoA (HMG-CoA) reductase activity in hamsters in a dose-dependent manner (ED50 = 31 mg/kg), and this was highly correlated with serum cholesterol lowering (r = 0.97). Cholesterol lowering by azalanstat and cholestyramine was additive, and the increase in HMG-CoA reductase brought about by cholestyramine was attenuated significantly by azalanstat. In vitro studies with HepG2 cells indicated that this modulation of reductase activity was indirect, occurring at a post-transcriptional step, and it is proposed that a regulatory oxysterol derived from dihydrolanosterol (or lanosterol) may be responsible for this regulation. Azalanstat does not appear to lower circulating cholesterol in the hamster by up-regulation of the hepatic LDL receptor, suggesting that other mechanisms are involved. Orally administered azalanstat (50-75 mg/kg) stimulated hepatic microsomal cholesterol 7 alpha-hydroxylase activity by 50-400% in hamsters, and it is postulated that this may result from modified cholesterol absorption and bile acid synthesis.
authors.affiliation: Institute of Biochemistry and Cell Biology, Syntex Research, Palo Alto, CA 94304, USA.
authors.forename: P M
authors.initials: PM
authors.lastname: Burton
authors.forename: D C
authors.initials: DC
authors.lastname: Swinney
authors.forename: R
authors.initials: R
authors.lastname: Heller
authors.forename: B
authors.initials: B
authors.lastname: Dunlap
authors.forename: M
authors.initials: M
authors.lastname: Chiou
authors.forename: E
authors.initials: E
authors.lastname: Malonzo
authors.forename: J
authors.initials: J
authors.lastname: Haller
authors.forename: K A
authors.initials: KA
authors.lastname: Walker
authors.forename: A
authors.initials: A
authors.lastname: Salari
authors.forename: S
authors.initials: S
authors.lastname: Murakami
mesh_terms: D000085:Acetates / Q000378:metabolism; D000814:Aniline Compounds / Q000494:pharmacology*; D000818:Animals; D000924:Anticholesteremic Agents / Q000494:pharmacology*; D001055:Apolipoproteins B / Q000097:blood; D002460:Cell Line; D002784:Cholesterol / Q000096:biosynthesis* / Q000097:blood; D006224:Cricetinae; D065607:Cytochrome P-450 Enzyme Inhibitors; D004041:Dietary Fats / Q000008:administration & dosage; D006801:Humans; D006903:Hydroxymethylglutaryl CoA Reductases / Q000378:metabolism; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood; D008148:Lovastatin / Q000494:pharmacology; D008297:Male; D008647:Mesocricetus; D008798:Mevalonic Acid / Q000378:metabolism; D008862:Microsomes, Liver / Q000187:drug effects / Q000378:metabolism*; D010088:Oxidoreductases / Q000037:antagonists & inhibitors*; D012333:RNA, Messenger / Q000032:analysis; D011973:Receptors, LDL / Q000378:metabolism; D058886:Sterol 14-Demethylase; D013440:Sulfides / Q000494:pharmacology*
chemical_list: D000085:Acetates; D000814:Aniline Compounds; D000924:Anticholesteremic Agents; D001055:Apolipoproteins B; C548418:CYP51A1 protein, human; D065607:Cytochrome P-450 Enzyme Inhibitors; D004041:Dietary Fats; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008075:Lipoproteins, HDL; D008077:Lipoproteins, LDL; D012333:RNA, Messenger; D011973:Receptors, LDL; D013440:Sulfides; C082410:azalanstat; D002784:Cholesterol; D008148:Lovastatin; D010088:Oxidoreductases; D006903:Hydroxymethylglutaryl CoA Reductases; D058886:Sterol 14-Demethylase; D008798:Mevalonic Acid