Cynomolgus macaques are highly responsive to atherogenic diets, and the atherogenic response is influenced by lipoprotein diet composition. Atherogenic diet-fed cynomolgus macaques develop coronary artery lesions, raised plasma cholesterol levels, and lesions of similar composition to humans. Atherosclerosis development in cynomolgus macaques is highly influenced by genetic predisposition, confounding diseases (such as diabetes mellitus), exercise, sex (increased susceptibility in men), and behavioral and psychosocial factors. Objectives-The predictive value of animal and in vitro systems for drug development is limited, particularly for nonhuman primate studies as it is difficult to deduce the drug mechanism of action. We describe the development of an in vitro cynomolgus macaque vascular system that reflects the in vivo biology of healthy, atheroprone, or advanced inflammatory cardiovascular disease conditions. Approach and Results-We compare the responses of the in vitro human and cynomolgus vascular systems to 4 statins.Although statins exert beneficial pleiotropic effects on the human vasculature, the mechanism of action is difficult to investigate at the tissue level. Using RNA sequencing, we quantified the response to statins and report that most statins significantly increased the expression of genes that promote vascular health while suppressing inflammatory cytokine gene expression. Applying computational pathway analytics, we identified statin-regulated biological themes, independent of cholesterol lowering, that provide mechanisms for off-target effects, including thrombosis, cell cycle regulation, glycogen metabolism, and ethanol degradation. Conclusions-The cynomolgus vascular system described herein mimics the baseline and inflammatory regional biology of the human vasculature, including statin responsiveness, and provides mechanistic insight not achievable in vivo. All of these characteristics are similar to the human atherosclerosis disease, and thus, they make cynomolgus macaques a good nonhuman primate model for atherosclerosis. 7,8 In this study, a cynomolgus vascular system was developed using primary endothelial cells (ECs), smooth muscle cells (SMCs), and hemodynamics derived in vivo from cynomolgus arteries. The system was validated against inflammatory risk factor response, including a comparison between human-and cynomolgus-derived oxidized low-density lipoproteins (LDLs), and exposure to several statins. A comparative analysis between the cynomolgus and human vascular tissue systems was conducted to determine the cross-species translational capabilities of these models, which is an important component in the transition from preclinical to human clinical studies.
Materials and MethodsMaterials and Methods are available in the online-only Data Supplement.
Results
Development of an In Vitro Cynomolgus Vascular Surrogate SystemThe human vascular surrogate system applies human-derived blood shear stress patterns to a transwell vascular coculture of ECs and SMCs ( Figure 1A). Atherosclerotic...