How a tweet about a gene discovered long ago led to a $190 million startup and, maybe, hope for heart disease

A 10-person startup called Marea said Tuesday that it had raised $190 million to help develop a drug to lower a type of cholesterol — what scientists call “remnant cholesterol” — that could represent a new way of attacking cardiovascular disease.

The story of that drug, the protein that it targets, and the gene that codes for that protein (both are called ANGPTL4) says a lot about why medicines are so tough to develop and why heart disease remains the biggest killer in the U.S., taking 700,000 lives every year. It also offers a freeze-frame photo of the way in which the biotech industry’s capitalist flywheel of boom and bust cycles provides glimmers of scientific hope.

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Marea, which is about three years old, is still at the beginning of its scientific journey. Its drug, initially developed at Novartis and then licensed to the startup, is only about to enter Phase 2 trials. For heart drugs, real proof of efficacy can require large Phase 3 trials. ANGPTL4, in particular, has a history that stretches back a quarter century — and was explored by several major drugmakers but, apparently, abandoned, because of a worry about side effects in mice.

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