Modifications of the 22A apoA-I mimetic peptide sequence improve the anti-atherosclerotic properties of synthetic HDL

Synthetic high-density lipoprotein (sHDL) constituted of apolipoprotein A-I (apoA-I) mimetic peptides and phospholipids are nanometer-scale particles designed to recreate biological functions of HDL particles in the context of cardiovascular disease. Particularly, the therapeutic efficacy of sHDL particles is attributed to their ability to promote reverse cholesterol transport (RCT), a process where accumulated cholesterol is transported from peripheral tissues to the liver for elimination. Here, we designed two novel apoA-I mimetic peptides (22A-F and 22A-P-18A) by modifying the sequence of the well-studied apoA-I mimetic peptide 22A. These modifications were intended to improve cholesterol efflux from macrophages in vitro and structural stability of sHDL particles in human plasma while preserving their ability to activate lecithin-cholesterol acyltransferase (LCAT). We performed a systematic examination of the potency of sHDL particles made with these peptides in cellular cholesterol efflux, activation of LCAT, plasma HDL remodeling and proteolytic stability. Our study highlights that these modifications improve cholesterol efflux and, in the case of 22A-P-18A, also cholesterol esterification rate by LCAT but they do not appear to influence HDL remodeling in human plasma. Nonetheless, the LCAT activity assay conducted in human plasma suggest that intact sHDL particles are present and are likely the primary contributors to the increased cholesterol esterification rate, rather than the pre-{beta} HDL fraction generated through HDL remodeling. These findings offer new mechanistic insights into how specific peptide modifications affect key steps in RCT, laying the groundwork for future studies to explore their functional relevance in atherosclerosis and HDL-based drug delivery applications.