Recombinant apolipoprotein A-IMilano for the treatment of cardiovascular diseases

Curr Atheroscler Rep. 2006 Mar;8(2):163-7. doi: 10.1007/s11883-006-0054-4.


Apolipoprotein A-I(Milano) (apoA-I(M)) is a natural variant of apoA-I characterized by a cysteine for arginine substitution at position 173 of the primary sequence. ApoA-I(M) carriers have much less atherosclerosis than expected from their very low plasma high-density lipoprotein (HDL) cholesterol levels, suggesting that the variant might be protective. Synthetic HDL (sHDL) made with a recombinant form of the dimeric A-I(M) (A-I(M)/A-I(M)) and phospholipids given in single or multiple injections is effective in inducing the regression of atherosclerotic plaques, preventing arterial restenosis, and limiting cardiac dysfunction after ischemia/reperfusion injury. In a phase II trial in patients with acute coronary syndromes, a short-term treatment with A-I(M)/A-I(M) sHDL caused a remarkable reduction of atheroma burden. Although at early stages of drug development, A-I(M)/A-I(M) sHDL holds vast promise for the treatment of a variety of cardiovascular diseases in humans.

Publication types

  • Review

MeSH terms

  • Animals
  • Apolipoprotein A-I / therapeutic use*
  • Cardiovascular Diseases / blood
  • Cardiovascular Diseases / drug therapy*
  • Cholesterol, HDL / blood
  • Cholesterol, HDL / drug effects
  • Humans
  • Treatment Outcome


  • Apolipoprotein A-I
  • Cholesterol, HDL
  • apolipoprotein A-I Milano