Synthetic
high-density lipoproteins nanomedicine (sHDL) composed of
apolipoprotein A-I (
ApoA-I) mimetic
peptides and
lipids have shown very promising results for the treatment of various
cardiovascular diseases. Numerous efforts have also been made to design different
ApoA-I mimetic
peptides to improve the potency of sHDL, especially the efficiency of reverse
cholesterol transport. However, the way in which
ApoA-I mimetic
peptides affect the properties of sHDL, including stability,
cholesterol efflux,
cholesterol esterification, elimination in vivo, and the relationship of these properties, is still poorly understood. Revealing the effect of these factors on the potency of sHDL is important for the design of better
ApoA-I mimetic
peptides. In this study, three widely used
ApoA-I mimetic
peptides with different sequences, lengths, LCAT activation and
lipid binding affinities were used for the preparation of sHDL and were evaluated in terms of physical/chemical properties,
cholesterol efflux,
cholesterol esterification, remodeling, and pharmacokinetics/pharmacodynamics. Our results showed that
ApoA-I mimetic
peptides with the highest
cholesterol efflux and
cholesterol esterification in vitro did not exhibit the highest
cholesterol mobilization in vivo. Further analysis indicated that other factors, such as pharmacokinetics and remodeling of sHDL, need to be considered in order to predict the efficiency of
cholesterol mobilization in vivo. Thus, our study highlights the importance of using the overall performance, rather than in vitro results alone, as the blueprint for the design and optimization of
ApoA-I mimetic
peptides.