Cholesterol absorption inhibitor reactions

The technique of chiral auxiliaries was exploited in a synthesis of cholesterol absorption inhibitors, based on an imino-Reformatsky reaction between bromoacetates of chiral alcohols (e.g. 69a and 69b) and imine 70. Virtual complete asymmetric induction was found with (-)-trans-2-phenylcyclohexanol and (—)-phenyl substituted menthol derived chiral auxiliaries (equation 43)126. 

Chlorophenyl)glutarate monoethyl ester 87 was reduced to hydroxy acid and subsequently cyclized to afford lactone 88. This was further submitted to reduction with diisobutylaluminium hydride to provide lactol followed by Homer-Emmons reaction, which resulted in the formation of hydroxy ester product 89 in good yield. The alcohol was protected as silyl ether and the double bond in 89 was reduced with magnesium powder in methanol to provide methyl ester 90. The hydrolysis to the acid and condensation of the acid chloride with Evans s chiral auxiliary provided product 91, which was further converted to titanium enolate on reaction with TiCI. This was submitted to enolate-imine condensation in the presence of amine to afford 92. The silylation of the 92 with N, O-bis(trimethylsilyl) acetamide followed by treatment with tetrabutylammonium fluoride resulted in cyclization to form the azetidin-2-one ring and subsequently hydrolysis provided 93. This product was converted to bromide analog, which on treatment with LDA underwent intramolecular cyclization to afford the cholesterol absorption inhibitor spiro-(3-lactam (+)-SCH 54016 94. 

Researchers at Schering Plough were interested in preparing a variety substituted Azetidinones for testing as Cholesterol Absorption Inhibitors. In that sense, the Heck reaction is known to be an effective reaction that provides a useful diversity element and was employed as such. Heck reaction of 5-bromopyridine with chiral the terminal olefin provided the desired product [118]. 

Dietary cholesterol is absorbed by intestinal ABC cholesterol transporter (Chapter 41). Once inside the cell, cholesterol is esterified by acyl CoA-cholesterol-acyl transferase (ACAT) to form the hydro-phobic cholesteryl ester. This reaction facilitates and maximises absorption of cholesterol, which is probably an advantage to people deprived of cholesterol-rich food such as meat. Unfortunately, efficient absorption of cholesterol is not an advantage to the affluent. However, margarines enriched with plant sterols have been used to inhibit cholesterol absorption in an attempt to lower blood cholesterol. Research is under way to develop ACAT inhibitors that potentially are cholesterol-lowering drugs. Ezetimibe is a new drug that inhibits cholesterol absorption by inhibition of the intestinal cholesterol-transporter protein NPCILI (Niemann-Pick Cl-like protein 1). 

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