Deficiency of Niemann-Pick C1 Like 1 Prevents Atherosclerosis in ApoE−/−Mice

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Abstract
Objective—The objective of this study was to determine whether the deficiency of Niemann-Pick C1 Like 1 (Npc1l1) prevents atherosclerosis in apoE null mice.Methods and Results—Npc1l1−/−/apoE null−/−mice were generated and found to have a significant reduction in cholesterol absorption (−77%) compared with wild-type or apoE−/−mice. Npc1l1/apoE−/−mice were fed a chow or Western diet for 24 weeks, then lipoprotein, hepatic, and biliary cholesterol, and atherosclerosis development was compared with apoE−/−, Npc1l1−/−, wild-type, and ezetimibe-treated apoE−/−mice. Chylomicron remnant/ VLDL cholesterol levels were reduced 80% to 90% in both chow and Western diet-fed Npc1l1/apoE−/−mice relative to apoE−/−mice. Male Npc1l1−/−and Npc1l1/apoE−/−mice were completely resistant to diet induced hypercholesterolemia, and both male and female mice were completely resistant to increases in hepatic and biliary cholesterol levels. Atherosclerosis was reduced 99% in aortic lesion surface area, 94% to 97% in innominate artery intimal lesion area, and >90% in aortic root lesion area in both male and female Npc1l1/apoE−/−mice relative to apoE−/−mice.Conclusions—Lack of Npc1l1, the molecular target of the cholesterol absorption inhibitor ezetimibe, in apoE−/−mice results in a significant reduction in cholesterol absorption and plasma cholesterol levels, and causes a nearly complete protection from the development of atherosclerosis, under both cholesterol-fed and non-cholesterol-fed conditions.

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