A Systematic Review of Apolipoprotein A-I Mimetic Peptides for Atherosclerosis Therapy via Activation of Reverse Cholesterol Transport Pathway

HDL has been identified as a potential new treatment for atherosclerosis. Targeting lipid metabolism via the Reverse Cholesterol Transport (RCT) pathway can improve HDL metabolism. Apolipoprotein A-I mimetic peptides (ApoA-I MPs) are able to increase HDL metabolism. Thus, this systematic review aimed to examine the potential effect of ApoA-I MPs against atherosclerosis in mice models through the RCT mechanism.

This systematic review was conducted using previous in vivo studies published in four scientific databases over the last ten years (PubMed, SCOPUS, ProQuest, and Science Direct) and was based on the Systematic Review Protocol for Animal Intervention Studies (SYRCLE) protocol. 

This study’s primary outcome was a reduction in atherosclerotic plaque, where 16 articles were qualified for this study. Based on the risk of bias analysis, these articles had a low risk of bias. Most in vivo studies (13 of 16) showed that ApoA-I MPs significantly reduced atherosclerotic plaque formation. Generally, ApoA-I MPs played an important role in regulating HDL metabolism (HDL remodeling process, increased cholesterol efflux, and stimulated RCT pathway) and anti-inflammatory agent. ApoA-I MPs may differ in their ability to reduce atherosclerotic plaque depending on the peptide sequence and administration route.

ApoA-I MPs can reduce atherosclerotic plaque formation in mice by increasing cholesterol efflux via the RCT pathway. Further investigation is required to support the development of ApoA-I MPs as a new therapy for atherosclerosis in humans.