Nasal spray to prevent fat and plaque built up in the heart on the horizon

By Dr. Ananya Mandal, MDApr 1 2012

Soon there will be a nasal spray to remove the fats in arteries which dramatically raises the risk of heart attacks. The revolutionary product could be on the market in five years, it is speculated.

Researchers found a ­treatment that was much more effective in removing fat from arteries than established methods. The vaccine can be given as an injection or in a slightly different form as a nasal spray. A trial on 144 heart disease sufferers is under way in the US and Canada.

Working with Prof Prediman Shah, from Cedars-Sinai Heart Institute in Los Angeles, the team were able to formulate a vaccine that reduced plaque build up by 60 to 70 per cent in mice. The resulting CVX-210 vaccine, currently in development as an injection by CardioVax, is waiting regulatory clearance to start clinical trials.

Professor Peter Weissberg, Medical Director at the British Heart Foundation said, “A vaccination approach to the treatment of atherosclerosis is based on an attempt to interfere with the cellular mechanisms that cause life threatening build up of fatty deposits. There will be great interest in the outcome of the on-going studies to see firstly if this approach is safe and secondly, whether it can influence the progression of vascular disease in the long term. It is very promising, but it will take some time before we know if it is successful and, if so, which patients are likely to benefit most from this treatment.” It works by stimulating the body’s immune system to produce antibodies which tackle the build-up of fatty deposits in arteries called plaque. A study by Lund University in Sweden found it could reduce plaque by 60 to 70% during tests on mice.

The fat places great strain on the heart by narrowing the arteries and forcing it to pump far harder. There are at least 2.7 million Britons with heart disease, costing the NHS £3billion a year. Lack of exercise, poor diet, smoking and drinking too much alcohol are the main causes of heart disease but it is also known that there are strong hereditary factors too. It is the first time that the underlying cause of heart disease has been targeted. Current treatments focus on using drugs to reduce cholesterol levels and blood pressure.

Prof Jan Nilsson, professor of experimental cardiovascular research at Lund University, acknowledged that treatments such as statins and blood pressure drugs reduced the risk of heart disease by 40 per cent, but added, “It should not be forgotten that 60 per cent of cardiovascular events continue to occur….These treatments are far more like drugs: to be effective they'd need to be given long term. The antibody therapy in particularly is likely to be expensive, so you could probably only afford to give it to high-risk populations rather than everyone.”

Another approach, of directly injecting antibodies against bad low density lipoprotein which carries cholesterol in the blood and forms the basis of the plaque, is already in trials. Prof Nilsson said, “The rationale is that since oxidized LDL plays a major role in the development of atherosclerotic plaques and harmful inflammatory processes, directly targeting oxidized LDL should prevent plaque formation and reduce inflammation.” Early studies have shown that the antibody, called BI-204, developed jointly by BioInvent and Genentech, reduced plaques by half and was well tolerated when tested in 80 healthy people.

The results of the research were presented at the Frontiers in CardioVascular Biology conference at Imperial College London.