Heat shock proteins and cholesterol homeostasis

1. A method for treatment of Smith-Lemli-Opitz Syndrome (SLOS) in a subject, said method comprising administering a bioactive agent selected from the group consisting of: a hydroxylamine derivative small molecule; and Hsp70 protein, or a functional fragment of Hsp70 protein, or a functional variant of Hsp70 protein; to the subject, thereby treating said subject.

2. The method according to claim 1 , wherein the hydroxylamine derivative small molecule is selected from the group consisting of: N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride (arimoclomol), a stereoisomer thereof, an acid addition salt of arimoclomol, and an acid addition salt of a stereoisomer of arimoclomol.

3. The method according to claim 1 , wherein the hydroxylamine derivative small molecule is selected from the group consisting of:

a. a racemate of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride,

b. an optically active stereoisomer of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride,

c. an enantiomer of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride,

d. (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride and (−)—(S)—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride,

e. an acid addition salt of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride,

f. N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride citrate (BRX-345), and N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride maleate, and

g. (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride citrate; (−)—S—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride citrate; (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride maleate; and (−)—S—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride maleate.

4. The method according to claim 1 , wherein the hydroxylamine derivative small molecule is selected from the group consisting of:

a. N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-pyridine-1-oxide-3-carboximidoyl chloride (arimoclomol), a stereoisomer, or an acid addition salt thereof,

b. N-[2-hydroxy-3-(1-piperidinyl)propoxy]-3-pyridinecarboximidamide dihydrochloride (BGP-15), a stereoisomer, or an acid addition salt thereof,

c. N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride (bimoclomol), a stereoisomer, or an acid addition salt thereof, and

d. 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine (iroxanadine), a stereoisomer, or an acid addition salt thereof.

5. The method according to claim 1 , wherein the hydroxylamine derivative small molecule is selected from the group consisting of:

a. a racemate of 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine,

b. an optically active stereoisomer of 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine,

c. an enantiomer of 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine,

d. (+)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine and (−)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine,

e. an acid addition salt of 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine,

f. 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine citrate, and 5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine maleate, and

g. (+)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine citrate; (−)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine citrate; (+)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine maleate; and (−)-5,6-dihydro-5-(1-piperidinyl)methyl-3-(3-pyridyl)-4H-1,2,4-oxadiazine maleate.

6. The method according to claim 1 , wherein the hydroxylamine derivative small molecule is selected from the group consisting of:

a. a racemate of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride,

b. an optically active stereoisomer of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride,

c. an enantiomer of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridine-carboximidoyl chloride,

d. (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride and (−)—(S)—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride,

e. an acid addition salt of N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride,

f. N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride citrate, and N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride maleate, and

g. (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride citrate; (−)—S—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride citrate; (+)—R—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride maleate; and (−)—S—N-[2-hydroxy-3-(1-piperidinyl)-propoxy]-3-pyridinecarboximidoyl chloride maleate.

7. The method according to claim 1 , wherein said Hsp70 protein is selected from the group consisting of: HSPA1A (SEQ ID NO:1 and SEQ ID NO:2), HSPA1B (SEQ ID NO:4 and SEQ ID NO:5), a functional fragment of any thereof, and a functional variant of any thereof.

8. The method according to claim 1 , wherein the functional variant of Hsp70 has at least 90% identity to an Hsp70 protein selected from the group consisting of: HSPA1A (SEQ ID NOs:1 and 2), HSPA1B (SEQ ID NOs: 4 and 5), and a fragment of any thereof.

9. The method according to claim 1 , wherein said Hsp70 protein is recombinant Hsp70 (rHsp70).

10. The method according to claim 1 , wherein said functional variant of Hsp70 is a naturally occurring variant, or a fragment of a naturally occurring variant, of Hsp70.

11. A method for one or more of:

i. stimulating cholesterol efflux from macrophages,

ii. stimulating the decrease of cholesterol esters in macrophages,

iii. facilitating cholesterol reduction during macrophage foam cell reversal,

iv. reducing intracellular cholesterol in macrophages,

v. increasing or stimulating ABCA1 levels or activity,

vi. increasing or stimulating ABCA1-protein levels or activity, and

vii. increasing or stimulating ABCA1-mRNA levels or activity;

in a subject, said method comprising administering a bioactive agent selected from the group consisting of: a hydroxylamine derivative small molecule; Hsp70 protein, or a functional fragment or functional variant thereof to the subject, thereby achieving one or more of i. to vi.

12. The method according to claim 1 , wherein said functional fragment of Hsp70 comprises or consists of at least 150 contiguous amino acids derived from Hsp70.