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Hua M, Chen WY, Wang LH, Zou XH, Mao LL. The value of serum Lp-PLA2 combined with MPO in the diagnosis of cerebral infarction caused by large artery atherosclerosis. Clin Neurol Neurosurg 2023; 232:107899. [PMID: 37467579 DOI: 10.1016/j.clineuro.2023.107899] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/25/2023] [Accepted: 07/15/2023] [Indexed: 07/21/2023]
Abstract
OBJECTIVE To explore the value of serum lipoprotein-associated phospholipase A2(Lp-PLA2)combined with myeloperoxidase(MPO)for the diagnosis of large artery atherosclerosis(LAA) cerebral infarction. METHODS Baseline data were collected from patients with first-ever acute cerebral infarction, serum Lp-PLA2 and MPO levels were measured. The etiology of cerebral infarction was classified according to the Chinese Ischemic Stroke Subtype Classification Standard. The risk factors associated with LAA cerebral infarction were identified by univariate and multivariate regression analysis. The diagnostic value of serum Lp-PLA2 and MPO for LAA cerebral infarction was assessed by the area under the receiver-operating characteristic (ROC) curve. RESULTS Overall 368 patients were involved, 148 patients (40.22 %) were LAA. The serum La-PLA2 and MPO levels were higher in the LAA group than those in non-LAA group (23.06 ± 3.39 ng/mL versus 17.48 ± 3.26 ng/mL; 93.60 ± 9.58 ng/mL versus 75.98 ± 15.53 ng/mL; P < 0.001 for both). Multivariate analysis showed that elevated levels of serum Lp-PLA2 (OR 1.742, 95 %CI 1.499-2.025; P < 0.001) and MPO (OR 1.060, 95 % CI 1.026-1.096; P = 0.001) were the independent risk factors of LAA cerebral infarction. The area under curve of the serum Lp-PLA2 combined with MPO for the diagnosis of LAA cerebral infarction was 0.896 [0.866 ∼ 0.927] (P < 0.001). CONCLUSION Serum Lp-PLA2 combined with MPO could be valued as a predictor of acute cerebral infarction caused by large artery atherosclerosis.
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Affiliation(s)
- Min Hua
- Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China
| | - Wen-Ya Chen
- Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China
| | - Li-Hui Wang
- Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China
| | - Xiao-Hua Zou
- Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China
| | - Lun-Lin Mao
- Department of Neurology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou 213002, Jiangsu Province, China.
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Yan P, Cao J, Zhou Y, Zhou X, Sun Z, Zhu X. Serum levels of sLOX-1 and Lp-PLA2 can predict the prognosis of acute cerebral infarction with a high specificity. Physiol Rep 2022; 10:e15160. [PMID: 35005850 PMCID: PMC8744129 DOI: 10.14814/phy2.15160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 12/11/2021] [Accepted: 12/13/2021] [Indexed: 06/14/2023] Open
Abstract
Soluble lectin-like oxidized low-density lipoprotein receptor-1 (sLOX-1) and lipoprotein-associated phospholipase A2 (Lp-PLA2) plays an important role in acute cerebral infarction (ACI), whereas its clinical value in predicting the prognosis is unclear. Thus, this study aimed to explore this issue. A total of 127 ACI patients were included in this prospective observational study. The concentrations of sLOX-1 and Lp-PLA2 in serum were measured and their relationship with a poor prognosis 90 days after the onset of ACI was analyzed. We found that patients with poor prognosis had higher mean serum levels of sLOX-1 and Lp-PLA2. The level of sLOX-1 and Lp-PLA2 could predict the functional outcome of ACI. At the optimal cut off value of sLOX-1 level (1257.92 ng/ml), the sensitivity and specificity for the poor functional outcome were 0.69 and 0.753, respectively, and the area under ROC curve (AUC) was 0.727. Similarly, the optimal value for Lp-PLA2 level was 160.9 ng/ml, at which the sensitivity and specificity were 0.643 and 0.835, respectively; and the AUC was 0.758. When the two biomarkers were used in combination, the AUC was 0.855, and the sensitivity and specificity were 0.643 and 0.976, respectively, indicating a significant improvement of the diagnostic specificity. The level of sLOX-1 or Lp-PLA2 could thus serve as useful biomarkers to predict the functional outcome of ACI. Combined use of both indicators is better than the use of either single indicator, and provides the highest specificity in predicting poor prognosis.
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Affiliation(s)
- Ping Yan
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Jing Cao
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Yajun Zhou
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Xia Zhou
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Zhongwu Sun
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
| | - Xiaoqun Zhu
- Department of NeurologyThe First Affiliated Hospital of Anhui Medical UniversityHefeiChina
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Sheng G, Zhou J, Zhang C, Wu C, Huang K, Qin X, Wu J. Relationship between Lp-PLA2 and in-stent restenosis after coronary stenting: a 3-year follow-up study. Scott Med J 2021; 66:178-185. [PMID: 34315293 DOI: 10.1177/00369330211034809] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND AIMS Coronary in-stent restenosis (ISR) is an important complication of percutaneous coronary intervention (PCI). However, the relationship between lipoprotein associated phospholipase A2 (Lp-PLA2) level and ISR after PCI is rarely reported. This study aims to explore the relationship between Lp-PLA2 and the occurrence of ISR at post-PCI and its predictive value for ISR. METHODS AND RESULTS Plasma Lp-PLA2 mass were measured in 847 patients planting 1262 stents and evaluated along with known risk indicators. One-year angiographic follow-up showed that baseline elevated Lp-PLA2 mass was strongly associated with early restenosis (95% CI = 1.062-3.050, P < 0.05). Beyond the first year, the occurrence of late restenosis (95% CI = 1.043-3.214, P < 0.05) was significantly larger in the elevated Lp-PLA2 group. Kaplan-Meier analysis after three-year clinical follow up suggested that Lp-PLA2 mass did add the positive effect on the occurrence of major adverse cardiovascular events (MACEs). CONCLUSION In conclusion, increased baseline plasma Lp-PLA2 predicts increased risks of re-stenosis and MACEs, which may be a novel biomarker for predicting ISR and MACEs.
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Affiliation(s)
- Guohua Sheng
- Deputy Chief Physician, Department of Cardiology, Haimen Hospital of Nantong University, China
| | - Juan Zhou
- Deputy Chief Physician, Department of Medical Imaging, Radiology Center, Haimen Hospital of Nantong University, China
| | - Chi Zhang
- Attending physician, Department of Cardiology, First Affiliated Hospital of Soochow University, China
| | - Caijuan Wu
- Chief Physician, Department of Cardiology, Haimen Hospital of Nantong University, China
| | - Kairong Huang
- Attending physician, Department of Cardiology, Haimen Hospital of Nantong University, China
| | - Xiaotong Qin
- Chief Physician, Department of Cardiology, Affiliated Hospital of Nantong University, China
| | - Jie Wu
- Chief Physician, Department of Cardiology, Haimen Hospital of Nantong University, China
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Zhuo S, Yuan C. Association with lipids or detergents is essential for preservation of the active structure of lipoprotein-associated phospholipase A 2. Chem Phys Lipids 2019; 225:104814. [PMID: 31493387 DOI: 10.1016/j.chemphyslip.2019.104814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 08/16/2019] [Accepted: 08/23/2019] [Indexed: 11/28/2022]
Abstract
Recombinant lipoprotein-associated phospholipase A2 (rLp-PLA2) expressed in HEK293 cells has a propensity to form oligomers in the absence of detergents. Dilution of rLp-PLA2 in the absence of detergents results in irreversible inactivation of the enzyme. The monomeric rLp-PLA2 may expose its hydrophobic interfacial binding region or substrate binding compartment to water and that may cause structural collapsing of the enzyme. Formation of self-aggregate, complex with binding partners or association with detergent micelles is to block the access of aqueous solvent to the hydrophobic substrate binding site and therefore prevents the structural collapsing. Dilution inactivation of the enzyme can be prevented in the presence of LDL or HDL suggesting that Lp-PLA2 association with lipoprotein particles (LDL and HDL) is necessary for Lp-PLA2 to maintain its enzymatic activity in human plasma. Formation of higher affinity complex gave better protection of rLp-PLA2 structure and activity. The method can be harnessed to detect the interaction between rLp-PLA2 and components of lipoprotein particles. Apo(a), ApoB 100 and ApoA1 were found to protect the enzyme from inactivation at roughly the similar level (˜80 ± 5%) comparing to human serum albumin control (˜40%). One mg/ml pig brain phospholipid showed 100% protection under the same conditions.
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Affiliation(s)
- Shaoqiu Zhuo
- Diazyme Laboratories, Inc., 12889 Gregg Ct., Poway, CA, 92064, United States.
| | - Chong Yuan
- Diazyme Laboratories, Inc., 12889 Gregg Ct., Poway, CA, 92064, United States
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Lipoprotein-Associated Phospholipase A2 Activity and Mass as Independent Risk Factor of Stroke: A Meta-Analysis. BIOMED RESEARCH INTERNATIONAL 2019; 2019:8642784. [PMID: 31236414 PMCID: PMC6545803 DOI: 10.1155/2019/8642784] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 04/24/2019] [Indexed: 02/07/2023]
Abstract
Background The association between lipoprotein-associated phospholipase A2 (Lp-PLA2) and stroke risk is inconsistent. We conducted a meta-analysis to determine whether elevated Lp-PLA2 is a risk factor for stroke. Methods Studies were included if they reported Lp-PLA2 mass and/or activity levels and adjusted risk estimates of stroke. The primary outcome was overall stroke incidence. The combined results were shown as relative risks (RRs) with 95% confidence intervals (CI) for per 1 standard deviation (SD) higher value of Lp-PLA2 and the highest versus lowest Lp-PLA2 category. Results Twenty-two studies involving 157,693 participants were included for analysis. After adjusting for conventional risk factors, the RRs for overall stroke with 1 SD higher Lp-PLA2 activity and mass were 1.07 (95% CI 1.02-1.13) and 1.11 (95% CI 1.04-1.19), respectively. The RRs of ischemic stroke with 1 SD higher Lp-PLA2 activity and mass were 1.08 (95% CI 1.01-1.15) and 1.11 (95% CI 1.02-1.22), respectively. When comparing the highest and lowest levels of Lp-PLA2, the RRs of stroke for Lp-PLA2 activity and mass were 1.26 (95% CI 1.03-1.54) and 1.56 (95% CI 1.21-2.00), respectively. Finally, when comparing the highest and lowest levels of Lp-PLA2, the pooled RRs of ischemic stroke for Lp-PLA2 activity and mass were 1.29 (95% CI 1.07-1.56) and 1.68 (95% CI 1.12-2.53), respectively. Conclusions Elevated baseline Lp-PLA2 levels, detected either by activity or mass, are associated with increased stroke risk.
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Abstract
Accumulating evidence has established that systemic inflammation is an important pathophysiologic factor of coronary heart disease (CHD). In this study, we investigated whether catechin exerts anti-inflammatory function in CHD rats. CHD model of rats was established by high-fat diet feeding and pituitrin injection. The successful building of CHD model was confirmed using blood liquid biochemical analyzer. Additionally, the effects of catechin on CHD parameters and several inflammatory signaling were investigated. The levels of total cholesterol, high-density lipoprotein, low-density lipoprotein cholesterin, triglyceride and blood glucose were all significantly elevated in CHD rats compared to them in control rats, suggesting the successful establishment of CHD model. Administration of catechin attenuated CHD by reversing the levels of creatine kinase, creatine kinase-MB, lactate dehydrogenase, cardiac troponin (cTnT), ventricular ejection fraction (LVEF) and systolic internal diameter (LVIDs). Additionally, several inflammatory biomarkers or cytokines such as C-reactive protein, lipoprotein-associated phospholipase A2 (Lp-PLA2), interleukin (IL)-6 and tumor necrosis factor-alpha (TNF-α) were inhibited by catechin. In contrast to nuclear factor-kappa beta (NF-κB), several proteins involved in inflammation such as farnesoid X receptor, signal transducers and activators of transcription (STAT)-3 and protein kinase B (PKB/Akt) were all activated by catechin. Catechin could be used as a promising treatment for CHD based on its role in suppressing inflammation and balancing STAT-3 signaling.
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Wang Y, Hu S, Ren L, Lei Z, Lan T, Cai J, Li C. Lp-PLA 2 as a risk factor of early neurological deterioration in acute ischemic stroke with TOAST type of large arterial atherosclerosis. Neurol Res 2018; 41:1-8. [PMID: 30296199 DOI: 10.1080/01616412.2018.1493850] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Introduction: Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a well-known risk factor of atherosclerotic vascular diseases. Nevertheless, its role in the acute phase of ischemic stroke is still unclear. The aim of this study is to identify the relationship between Lp-PLA2 levels and early neurological deterioration (END) in acute ischemic stroke patients with Trial of Org 10 172 in Acute Stroke Treatment (TOAST) subtype of large arterial atherosclerosis (LAA). Methods: We enrolled Chinese patients with first ever acute ischemic stroke admitted to Neurology Department of Shenzhen Second People's Hospital within 48 h from onset of symptoms during January - November 2015. Demographic and laboratory information were collected while END was defined as an increase in the National Institute of Health Stroke Scale score by ≥ 1 point in motor power, or ≥ 2 points in the total score within 10 days after admission. Results: Overall 181 patients were involved; END was diagnosed in 30 patients within 10 days after admission. The odds ratio for END increased with increasing levels of Lp-PLA2 (intermediate level, OR = 1.96, 95%CI 1.02-4.27, p = 0.041; high level, OR = 2.99, 95%CI 1.26-5.73, p = 0.023). Conclution: Intermediate and high level of Lp-PLA2 was identified as independent predictor of END in multivariate analysis. Lp-PLA2 could be valued as a risk factor of END in patients with acute ischemic stroke with TOAST subtype of LAA.
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Affiliation(s)
- Yang Wang
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Shiyu Hu
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Lijie Ren
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Zhihao Lei
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Tao Lan
- b Department of Orthopaedics , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Jingjing Cai
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
| | - Chao Li
- a Department of Neurology , Shenzhen University 1st Affiliated Hospital , Guangdong , China
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Impact of tyrosine nitration at positions Tyr307 and Tyr335 on structural dynamics of Lipoprotein-associated phospholipase A2–A therapeutically important cardiovascular biomarker for atherosclerosis. Int J Biol Macromol 2018; 107:1956-1964. [DOI: 10.1016/j.ijbiomac.2017.10.068] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 10/09/2017] [Accepted: 10/11/2017] [Indexed: 12/27/2022]
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Lipoprotein-associated Phospholipase A2 Is Associated with Risk of Mild Cognitive Impairment in Chinese Patients with Type 2 Diabetes. Sci Rep 2017; 7:12311. [PMID: 28951620 PMCID: PMC5615059 DOI: 10.1038/s41598-017-12515-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 09/12/2017] [Indexed: 12/18/2022] Open
Abstract
Type 2 diabetes mellitus (T2DM) is a low-grade chronic inflammatory diseases, which have been implicated in the pathogenesis of cognitive decline. We aim to evaluate associations between inflammatory markers and the risk of mild cognitive impairment (MCI) in T2DM. This study of 140 diabetic patients involved 71 with MCI and 69 controls. Clinical parameters, neuropsychological tests, high sensitivity C reactive protein (hsCRP), interleukin-6 (IL-6), lipoprotein-associated Phospholipase A2 (Lp-PLA2) mass and activity were measured. The results showed significantly higher plasma hsCRP, IL-6, Lp-PLA2 mass and activity in MCI group compared to controls. In T2DM with MCI, the Montreal Cognitive Assessment (MoCA) score was positively correlated with education level and high-density lipoprotein cholesterol (HDL-c), but inversely correlated with age, glycosylated hemoglobin, intima-media thickness (IMT), hsCRP, IL-6, and Lp-PLA2 mass and activity. Correlation analysis showed that both plasma Lp-PLA2 mass and activity were positively correlated with total cholesterol, low-density lipoprotein cholesterol, and IMT but negatively associated with MoCA score. Multivariable logistic regression analysis indicated higher hsCRP, Lp-PLA2 mass, Lp-PLA2 activity, and lower HDL-c to be independent risk factors increasing the possibility of MCI in T2DM. In conclusion, plasma Lp-PLA2 and hsCRP were found to be associated with the risk of MCI among T2DM patients.
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Kocak S, Ertekin B, Girisgin AS, Dundar ZD, Ergin M, Mehmetoglu I, Bodur S, Cander B. Lipoprotein-associated phospholipase-A 2 activity and its diagnostic potential in patients with acute coronary syndrome and acute ischemic stroke. Turk J Emerg Med 2017; 17:56-60. [PMID: 28616616 PMCID: PMC5459519 DOI: 10.1016/j.tjem.2016.10.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2016] [Revised: 10/09/2016] [Accepted: 10/11/2016] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND The study examined the Lp-PLA2 activity at the patients presented to the emergency department with acute coronary syndrome (ACS) or acute ischemic stroke (AIS), as well as its diagnostic value. METHODS The prospective study included consecutive male and female patients aged >18 years that presented to the our emergency department with ACS or AIS between November 2009 and January 2010. Blood samples were obtained immediately following diagnosis in the ACS and AIS groups. The diagnostic value of Lp-PLA2 was determined based on receiver operating characteristic curves, sensitivity, specificity, predictive values, likelihood ratios and accuracy rates. RESULTS In all, 34 ACS and 32 AIS patients were included in the study, and the control group included 35 patients. Lp-PLA2 enzyme activity was significantly lower in the ACS and AIS groups than in the control group (26.7 ± 13.8, 31.4 ± 13.6, and 41.4 ± 8.1 nmol min-1·mL-1, respectively; p < 0.0001, p = 0.022). In the ACS group the area under the curve (AUC) was 0.825 (95%CI: 0.722-0.929), sensitivity was 71% for an optimal Lp-PLA2 cut-off value of 31.4 nmol min-1·mL-1, and specificity was 91%, whereas in the AIS group the AUC was 0.768 (95%CI: 0.652-0.884), sensitivity was 75% for an optimal Lp-PLA2 cut-off value of 38.1 nmol min-1·mL-1, and specificity was 74%. CONCLUSIONS Lp-PLA2 enzyme activity was significantly lower during the early stage of both ACS and AIS. The obtained statistic data suggest that low Lp-PLA2 enzyme activity can be used for diagnostic purposes.
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Affiliation(s)
- Sedat Kocak
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Birsen Ertekin
- Emergency Department, Beyhekim State Hospital, Konya, Turkey
| | - Abdullah Sadik Girisgin
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Zerrin Defne Dundar
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Mehmet Ergin
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Idris Mehmetoglu
- Biochemistry Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
| | - Said Bodur
- Public Health Department, Balıkesir University Faculty of Medicine, Balıkesir, Turkey
| | - Basar Cander
- Emergency Department, Necmettin Erbakan University, Meram Faculty of Medicine, Konya, Turkey
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Pettersson ME, Koppelman GH, Flokstra-de Blok BMJ, van Ginkel CD, Roozendaal C, Muller-Kobold AC, Kollen BJ, Dubois AEJ. Apolipoprotein B: a possible new biomarker for anaphylaxis. Ann Allergy Asthma Immunol 2017; 118:515-516. [PMID: 28274733 DOI: 10.1016/j.anai.2017.01.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2016] [Revised: 01/10/2017] [Accepted: 01/22/2017] [Indexed: 11/17/2022]
Affiliation(s)
- Maria Eleonore Pettersson
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.
| | - Gerard H Koppelman
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Bertine M J Flokstra-de Blok
- GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Cornelia Doriene van Ginkel
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Caroline Roozendaal
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anneke C Muller-Kobold
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Boudewijn J Kollen
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - Anthony E J Dubois
- Department of Pediatric Pulmonology and Pediatric Allergology, Beatrix Children's Hospital, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands; GRIAC Research Institute, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Kheirandish-Gozal L, Philby MF, Qiao Z, Khalyfa A, Gozal D. Endothelial Dysfunction in Children With Obstructive Sleep Apnea Is Associated With Elevated Lipoprotein-Associated Phospholipase A2 Plasma Activity Levels. J Am Heart Assoc 2017; 6:e004923. [PMID: 28183716 PMCID: PMC5523777 DOI: 10.1161/jaha.116.004923] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2016] [Accepted: 12/15/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obstructive sleep apnea (OSA) is a highly prevalent condition, especially in obese children, and has been associated with increased risk for endothelial dysfunction and dislipidemia, which are precursors of atherosclerosis. Lipoprotein-associated phospholipase A2 (Lp-PLA2) is recognized as an independent risk factor for cardiovascular risk and atheromatous plaque activity. We hypothesized that Lp-PLA2 levels would be elevated in children with OSA, particularly among obese children who also manifest evidence of endothelial dysfunction. METHODS AND RESULTS One hundred sixty children (mean age 7.1±2.3 years), either nonobese with (n=40) and without OSA (n=40) or obese with (n=40) and without OSA (n=40) underwent overnight polysomnographic and postocclusive reperfusion evaluation and a fasting blood draw the morning after the sleep study. In addition to lipid profile, Lp-PLA2 plasma activity was assessed using a commercial kit. Obese children and OSA children had significantly elevated plasma Lp-PLA2 activity levels compared to controls. Furthermore, when both obesity and OSA were concurrently present or when endothelial function was present, Lp-PLA2 activity was higher. Treatment of OSA by adenotonsillectomy resulted in reductions of Lp-PLA2 activity (n=37; P<0.001). CONCLUSIONS Lp-PLA2 plasma activity is increased in pediatric OSA and obesity, particularly when endothelial dysfunction is present, and exhibits decreases on OSA treatment. The short-term and long-term significance of these findings in relation to cardiovascular risk remain undefined.
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Affiliation(s)
- Leila Kheirandish-Gozal
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Mona F Philby
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Zhuanghong Qiao
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - Abdelnaby Khalyfa
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
| | - David Gozal
- Section of Sleep Medicine, Department of Pediatrics, Pritzker School of Medicine, Biological Sciences Division, The University of Chicago, IL
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13
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Chen X, Wang K, Xu W, Ma Q, Chen M, Du L, Mo M, Wang Y, Shen J. Discovery of Potent and Orally Active Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) Inhibitors as a Potential Therapy for Diabetic Macular Edema. J Med Chem 2016; 59:2674-87. [PMID: 26927682 DOI: 10.1021/acs.jmedchem.5b01930] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered to be a promising therapeutic target for several inflammation-associated diseases. Herein, we describe the discovery of a series of pyrimidone derivatives as Lp-PLA2 inhibitors. Systematic structural modifications led to the identification of several pyrimidone compounds with promising in vitro inhibitory potency and pharmacokinetic properties. Compound 14c, selected for in vivo evaluation, demonstrated decent pharmacokinetic profiles and robust inhibitory potency against Lp-PLA2 in Sprague-Dawley (SD) rats. Furthermore, 14c significantly inhibited retinal thickening in STZ-induced diabetic SD rats as a model of diabetic macular edema (DME) after oral dosing for 4 weeks. Taken together, these results suggested that 14c can serve as a valuable lead in the search for new Lp-PLA2 inhibitors for prevention and/or treatment of DME.
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Affiliation(s)
- Xinde Chen
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Kai Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Wenwei Xu
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Quanxin Ma
- Laboratory Animal Research Center, Zhejiang Chinese Medical University , Hangzhou 310053, China
| | - Minli Chen
- Laboratory Animal Research Center, Zhejiang Chinese Medical University , Hangzhou 310053, China
| | - Lili Du
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Mingguang Mo
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Yiping Wang
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
| | - Jianhua Shen
- State Key Laboratory of Drug Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences , 555 Zuchongzhi Road, Shanghai 201203, China
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14
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Garg PK, Arnold AM, Hinckley Stukovsky KD, Koro C, Jenny NS, Mukamal KJ, Criqui MH, Furberg CD, Newman AB, Cushman M. Lipoprotein-Associated Phospholipase A2 and Incident Peripheral Arterial Disease in Older Adults: The Cardiovascular Health Study. Arterioscler Thromb Vasc Biol 2016; 36:750-6. [PMID: 26848158 DOI: 10.1161/atvbaha.115.306647] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2015] [Accepted: 01/25/2016] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Although prior studies report a relationship between elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) and incident cardiovascular disease, the prospective association of Lp-PLA2 with incident peripheral arterial disease (PAD) has not been studied. We investigated the association between Lp-PLA2 mass and activity and the risk of developing clinical PAD and low ankle-brachial index (ABI). APPROACH AND RESULTS Among Cardiovascular Health Study participants, a population-based cohort of 5888 adults aged ≥65 years enrolled in 1989 to 1990, Lp-PLA2 mass and activity were measured in 4537 individuals without baseline PAD. Clinical PAD, defined as leg artery revascularization or diagnosed claudication, was ascertained through 2011. Incident low ABI, defined as ABI <0.9 and decline of ≥0.15, was assessed among 3537 individuals who had an ABI >0.9 at baseline and a second ABI measurement 3 or 6 years later. Analyses were adjusted for demographics, cholesterol, smoking, comorbidities, and C-reactive protein. Each standard deviation increment in Lp-PLA2 mass (117 ng/mL) was associated with a higher risk of developing clinical PAD (hazard ratio 1.28; 95% confidence interval 1.13, 1.45) and incident low ABI (odds ratio 1.16; 95% confidence interval 1.00, 1.33). Results per standard deviation increment in Lp-PLA2 activity (13 nmol/min per mL) were similar for clinical PAD (hazard ratio 1.24; 95% confidence interval 1.07, 1.44) and low ABI (odds ratio 1.28; 95% confidence interval 1.09, 1.50). CONCLUSIONS Higher Lp-PLA2 mass and activity were associated with development of both incident clinical PAD and low ABI. Future studies are needed to determine whether pharmacological inhibition of Lp-PLA2 reduces the incidence of PAD.
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Affiliation(s)
- Parveen K Garg
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.).
| | - Alice M Arnold
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Karen D Hinckley Stukovsky
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Carol Koro
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Nancy S Jenny
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Kenneth J Mukamal
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Michael H Criqui
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Curt D Furberg
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Anne B Newman
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
| | - Mary Cushman
- From the Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles (P.K.G.); Department of Biostatistics, University of Washington, Seattle (A.M.A., K.D.H.S.); Glaxo Smith Kline, Collegeville, PA (C.K.); Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington (N.S.J., M.C.); Department of Medicine, Beth Israel Deaconess Medical Center, Boston, MA (K.J.M.); Department of Family and Preventive Medicine, University of California in San Diego School of Medicine, La Jolla (M.H.C.); Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC (C.D.F.); Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, PA (A.B.N.); and Department of Medicine, Cardiovascular Research Institute, University of Vermont College of Medicine, Burlington (M.C.)
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15
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Jarvie JL, Wang H, Kinney GL, Snell-Bergeon J, Hokanson JE, Eckel RH. Lipoprotein-associated phospholipase A2 distribution among lipoproteins differs in type 1 diabetes. J Clin Lipidol 2016; 10:577-86. [PMID: 27206945 DOI: 10.1016/j.jacl.2016.01.001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2013] [Revised: 12/16/2015] [Accepted: 01/03/2016] [Indexed: 01/07/2023]
Abstract
BACKGROUND LpPLA2 mass and activity have been variably related to cardiovascular disease risk, and the distribution of LpPLA2 in patients with type 1 diabetes (T1D), wherein cardiovascular disease risk is high despite normal or higher levels of high-density lipoprotein (HDL) cholesterol, is unknown. OBJECTIVE To determine whether there are differences in the distribution of LpPLA2 mass and activity across lipoproteins and their association with coronary artery calcium (CAC) in patients with T1D. METHODS Men with T1D (n = 19) not on statins, with and without CAC progression, and men without diabetes matched for HDL cholesterol (n = 25) had lipoproteins separated by fast protein liquid chromatography. RESULTS Both LpPLA2 mass and activity were found within low-density lipoprotein (LDL) and HDL pools with more LpPLA2 mass being associated with HDL (54% vs 44%; P-value <.001) and more LpPLA2 activity being associated with LDL (56% vs 40%; P value = .02). In T1D, more LpPLA2 activity was associated with large- or less-dense LDL compared to those without diabetes. However, no difference in LpPLA2 activity or mass between lipoprotein subfractions was observed between all groups, and there was no relationship between LpPLA2 activity or mass and its distribution and CAC score progression in healthy or T1D men. CONCLUSION LpPLA2 is found in both LDL and HDL and is distributed differently in men with T1D without any relationship to CAC score progression.
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Affiliation(s)
- Jennifer L Jarvie
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Hong Wang
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Gregory L Kinney
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Janet Snell-Bergeon
- Barbara Davis Center for Childhood Diabetes, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - John E Hokanson
- Department of Epidemiology, Colorado School of Public Health, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA
| | - Robert H Eckel
- Department of Medicine, University of Colorado, Anschutz Medical Campus, Aurora, CO, USA.
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16
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Abstract
Cardiovascular disease (CVD) is the most common cause of death and disability worldwide. Therefore, great importance has been placed on the discovery of novel risk factors and metabolic pathways relevant in the prevention and management of CVD. Such research is ongoing and may continue to lead to better risk stratification of individuals and/or the development of new intervention targets and treatment options. This review highlights emerging biomarkers related to lipid metabolism, glycemia, inflammation, and cardiac damage, some of which show promising associations with CVD risk and provide further understanding of the underlying pathophysiology. However, their measurement methodology and assays will require validation and standardization, and it will take time to accumulate evidence of their role in CVD in various population settings in order to fully assess their clinical utility. Several of the novel biomarkers represent intriguing, potentially game-changing targets for therapy.
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Affiliation(s)
- Leah E Cahill
- Department of Medicine, Dalhousie University, 5790 University Ave, Halifax, NS, B3H 1V7, Canada.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Monica L Bertoia
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Sarah A Aroner
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
| | - Kenneth J Mukamal
- Beth Israel Deaconess Medical Center, 1309 Beacon Street, 2nd Floor, Brookline, Boston, MA, USA.
| | - Majken K Jensen
- Department of Nutrition, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA, 02115, USA.
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17
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Chen X, Xu W, Wang K, Mo M, Zhang W, Du L, Yuan X, Xu Y, Wang Y, Shen J. Discovery of a Novel Series of Imidazo[1,2-a]pyrimidine Derivatives as Potent and Orally Bioavailable Lipoprotein-Associated Phospholipase A2 Inhibitors. J Med Chem 2015; 58:8529-41. [DOI: 10.1021/acs.jmedchem.5b01024] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- Xinde Chen
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Wenwei Xu
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Kai Wang
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Mingguang Mo
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Wei Zhang
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Lili Du
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Xiaojing Yuan
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Yechun Xu
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Yiping Wang
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
| | - Jianhua Shen
- State Key Laboratory of Drug
Research, Shanghai Institute of Materia Medica, Chinese Academy of Sciences, Shanghai 201203, China
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18
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Maiolino G, Bisogni V, Rossitto G, Rossi GP. Lipoprotein-associated phospholipase A2 prognostic role in atherosclerotic complications. World J Cardiol 2015; 7:609-620. [PMID: 26516415 PMCID: PMC4620072 DOI: 10.4330/wjc.v7.i10.609] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/11/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis manifests itself clinically at advanced stages when plaques undergo hemorrhage and/or rupture with superimposed thrombosis, thus abruptly stopping blood supply. Identification of markers of plaque destabilization at a pre-clinical stage is, therefore, a major goal of cardiovascular research. Promising results along this line were provided by studies investigating the lipoprotein-associated phospholipase A2 (Lp-PLA2), a member of phospholipase A2 proteins family that plays a key role in the metabolism of pro-inflammatory phospholipids, as oxidized low-density lipoproteins, and in the generation of pro-atherogenic metabolites, including lysophosphatidylcholine and oxidized free fatty acids. We herein review the experimental and clinical studies supporting use of Lp-PLA2 activity for predicting cardiovascular events. To his end we considered not only Lp-PLA2 activity and mass, but also Lp-PLA2 gene variations and their association with incident coronary artery disease, stroke, and cardiovascular mortality. Based on these evidences the major scientific societies have included in their guidelines the measurement of Lp-PLA2 activity among the biomarkers that are useful in risk stratification of adult asymptomatic patients at intermediate cardiovascular risk. The results of two recently published major clinical trials with the Lp-PLA2 inhibitor darapladib, which seem to challenge the pathogenic role of Lp-PLA2, will also be discussed.
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19
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Plasma PAF-AH (PLA2G7): Biochemical Properties, Association with LDLs and HDLs, and Regulation of Expression. Enzymes 2015; 38:71-93. [PMID: 26612648 DOI: 10.1016/bs.enz.2015.09.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
This chapter is focused on the plasma form of PAF-acetylhydrolase (PAF-AH), a lipoprotein-bound, calcium-independent phospholipase A2 activity also referred to as lipoprotein-associated phospholipase A2 and PLA2G7. PAF-AH catalyzes the removal of the acyl group at the sn-2 position of PAF and truncated phospholipids generated in settings of inflammation and oxidant stress. Here, I discuss current knowledge related to the structural features of this enzyme, including the molecular basis for association with lipoproteins and susceptibility to oxidative inactivation. The circulating form of PAF-AH is constitutively active and its expression is upregulated by mediators of inflammation at the transcriptional level. Several new mechanisms of regulation have been identified in recent years, including effects mediated by PPARs, VEGFR, and the state of cellular differentiation. Moreover, I discuss recent studies describing significant variations in the structure and regulation of PAF-AH from diverse species, which is likely to have important implications for the function of this enzyme in vivo.
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20
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Maiolino G, Lenzini L, Pedon L, Cesari M, Seccia TM, Frigo AC, Rossitto G, Caroccia B, Rossi GP. Lipoprotein-associated phospholipase A2 single-nucleotide polymorphisms and cardiovascular events in patients with coronary artery disease. J Cardiovasc Med (Hagerstown) 2015; 16:29-36. [PMID: 24732951 DOI: 10.2459/jcm.0000000000000057] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
AIMS We tested the hypothesis that variations in the PLA2G7 gene encoding the lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme deemed to have proatherogenic activity, affect the Lp-PLA2 levels and predicts cardiovascular events. METHODS Using a prospective cohort study design, we investigated incident cardiovascular events as a function of the PLA2G7 gene for rs1805017, rs1805018, and rs1051931 single-nucleotide polymorphisms (SNPs) in 643 randomly selected white patients from the GENICA Study, who at baseline underwent coronary angiography, measurement of Lp-PLA2 mass and activity. Cardiovascular event-free survival was compared across the genotypes by Cox regression, propensity score matching, and haplotype analysis. RESULTS The rs1805018 SNP did not follow the Hardy-Weinberg equilibrium and was not further explored. The rs1805017 GG genotype had a lower Lp-PLA2 mass and a higher Lp-PLA2 activity, thus suggesting that this SNP is functional. Long-term follow-up (median 7.8 years) was obtained in 75% of the cohort and allowed recording of incident cardiovascular events in 25.8% of the patients. On Cox regression analysis, the common rs1805017 GG genotype predicted acute myocardial infarction (AMI) [hazard ratio 1.75, 95% confidence interval (CI) 1.03-2.99, P = 0.041]; this finding was confirmed on propensity score matching (82.6% AMI-free survival in GG vs. 94.4% in GA + AA, P = 0.003). The rs1805017 and rs1051931 G/G haplotype was also associated with AMI (52.7 vs. 42.2%, P = 0.026) and cardiovascular event incidence (49.5 vs. 41.7%, P = 0.025). CONCLUSION In high-risk coronary artery disease patients of European ancestry, the PLA2G7 rs1805017 GG genotype is associated with increased Lp-PLA2 plasma activity and AMI.
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Affiliation(s)
- Giuseppe Maiolino
- aDepartment of Medicine - DIMED - Internal Medicine 4 bDivisione di Cardiologia, Ospedale di Cittadella, Cittadella cDepartment of Cardiac, Thoracic and Vascular Sciences, University of Padua, Padua, Italy
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Jensen MK, Bertoia ML, Cahill LE, Agarwal I, Rimm EB, Mukamal KJ. Novel metabolic biomarkers of cardiovascular disease. Nat Rev Endocrinol 2014; 10:659-72. [PMID: 25178732 DOI: 10.1038/nrendo.2014.155] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Coronary heart disease (CHD) accounts for one in every six deaths in US individuals. Great advances have been made in identifying important risk factors for CHD, such as hypertension, diabetes mellitus, smoking and hypercholesterolaemia, which have led to major developments in therapy. In particular, statins represent one of the greatest successes in the prevention of CHD. While these standard risk factors are important, an obvious opportunity exists to take advantage of ongoing scientific research to better risk-stratify individuals and to identify new treatment targets. In this Review, we summarize ongoing scientific research in a number of metabolic molecules or features, including lipoproteins, homocysteine, calcium metabolism and glycaemic markers. We evaluate the current state of the research and the strength of evidence supporting each emerging biomarker. We also discuss whether the associations with CHD are strong and consistent enough to improve current risk stratification metrics, and whether these markers enhance our understanding of the underlying biology of CHD and thus point towards new treatment options.
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Affiliation(s)
- Majken K Jensen
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA, USA
| | - Monica L Bertoia
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA, USA
| | - Leah E Cahill
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA, USA
| | - Isha Agarwal
- Department of Nutrition, Harvard School of Public Health, 665 Huntington Avenue, 02115 Boston, MA, USA
| | - Eric B Rimm
- Channing Division of Network Medicine, Brigham and Women's Hospital, Harvard Medical School, 181 Longwood Avenue, 02115 Boston, MA, USA
| | - Kenneth J Mukamal
- Department of Medicine, Beth Israel Deaconess Medical Centre, 1309 Beacon Street, 02446 Brookline, MA, USA
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22
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Fitzpatrick AL, Irizarry MC, Cushman M, Jenny NS, Chi GC, Koro C. Lipoprotein-associated phospholipase A2 and risk of dementia in the Cardiovascular Health Study. Atherosclerosis 2014; 235:384-91. [PMID: 24929287 PMCID: PMC4096578 DOI: 10.1016/j.atherosclerosis.2014.04.032] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Revised: 04/04/2014] [Accepted: 04/28/2014] [Indexed: 10/25/2022]
Abstract
OBJECTIVE To evaluate associations between Lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity with risk of dementia and its subtypes. METHODS Analysis were completed on 3320 participants of the Cardiovascular Health Study (CHS), a population-based longitudinal study of community-dwelling adults age ≥65 years followed for an average of 5.4 years. Baseline serum Lp-PLA2 mass was measured using a sandwich enzyme immunoassay and Lp-PLA2 activity utilized a tritiated-platelet activating factor activity assay. Cox proportional hazards regression assessed the relative risk of incident dementia with higher baseline Lp-PLA2 adjusting for demographics, cardiovascular disease (CVD) and risk factors, inflammation markers and apolipoprotein E (APOE) genotype. RESULTS Each standard deviation higher Lp-PLA2 mass and activity were related to increased risk of dementia (fully adjusted HR: 1.11 per SD, 95% CI: 1.00-1.24 for mass; HR: 1.12 per SD, 95% CI: 1.00-1.26 for activity). Persons in the highest quartile of Lp-PLA2 mass were 50% more likely to develop dementia than those in the lowest quartile in adjusted models (HR: 1.49; 95% CI: 1.08-2.06). Among dementia subtypes, the risk of AD was increased two-fold in the highest compared to lowest quartile of Lp-PLA2 mass (adjusted HR: 1.98, 95% CI: 1.22-3.21). Results were attenuated in models of mixed dementia and VaD. Lp-PLA2 activity also doubled the risk of mixed dementia in the highest compared to lowest quartile (HR: 2.21, 95% CI: 1.12-4.373). INTERPRETATION These data support Lp-PLA2 as a risk factor for dementia independent of CVD and its risk factors. Further study is required to clarify the role of Lp-PLA2-related mechanisms in dementia subtypes.
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Affiliation(s)
- Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, WA, USA; Department of Global Health, University of Washington, Seattle, WA, USA.
| | - Michael C Irizarry
- WW Epidemiology, GlaxoSmithKline, Research Triangle Park, NC and Upper Merion, PA, USA
| | - Mary Cushman
- Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA; Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Nancy S Jenny
- Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Gloria C Chi
- Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Carol Koro
- WW Epidemiology, GlaxoSmithKline, Research Triangle Park, NC and Upper Merion, PA, USA
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Feng L, Zhao Y, Feng G, Chen Y. Clinical application of elevated platelet-activating factor acetylhydrolase in patients with hepatitis B. Lipids Health Dis 2014; 13:105. [PMID: 24973921 PMCID: PMC4096520 DOI: 10.1186/1476-511x-13-105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2014] [Accepted: 06/26/2014] [Indexed: 01/30/2023] Open
Abstract
Background The aim of this study was to investigate the variation of platelet-activating factor acetylhydrolase (PAF-AH) in patients with various stages of hepatitis B infection and evaluate the association between PAF-AH activity and chronic severe hepatitis B (CSHB) and mortality in patients with hepatitis B. Methods Serum PAF-AH activity was measured in 216 patients with hepatitis B and in 152 healthy controls using an automatic biochemical analysis system. Spearman correlation was used to investigate the correlation between PAF-AH activity and other biochemical indicators. The receiver operating characteristic (ROC) curve and multivariable logistic regression analysis were used to evaluate the ability of PAF-AH activity to predict CSHB and mortality in patients with hepatitis B. Results The PAF-AH activities in patients with CSHB (1320 ± 481 U/L) were significantly higher than those in healthy controls and in other hepatitis B groups (all P < 0.01). In patients with hepatitis B, PAF-AH activity correlated with total bilirubin (r = 0.633), total bile acid (r = 0.559), aspartate aminotransferase (r = 0.332), apolipoprotein B (r = 0.348), high-density lipoprotein cholesterol (r = −0.493), and apolipoprotein AI (r = −0.530). The areas under the ROC curves for the ability of PAF-AH activity to predict CSHB and mortality in patients with hepatitis B were 0.881 (95% confidence interval (CI): 0.824–0.937, P < 0.001) and 0.757 (95% CI: 0.677–0.837, P < 0.001), respectively. Multivariate logistic regression analysis showed PAF-AH activity to be an independent factor predicting CSHB with an odds ratio of 1.003 (95% CI: 1.002–1.005, P < 0.001). Conclusion Elevated PAF-AH in patients with hepatitis B was significantly associated with liver damage. Thus, serum PAF-AH could be used as a novel indicator for predicting CSHB and mortality in patients with hepatitis B. Further, PAF-AH activity was an independent factor predicting CSHB.
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Affiliation(s)
| | | | | | - Yu Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, China.
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Sheu JJ, Lin PY, Sung PH, Chen YC, Leu S, Chen YL, Tsai TH, Chai HT, Chua S, Chang HW, Chung SY, Chen CH, Ko SF, Yip HK. Levels and values of lipoprotein-associated phospholipase A2, galectin-3, RhoA/ROCK, and endothelial progenitor cells in critical limb ischemia: pharmaco-therapeutic role of cilostazol and clopidogrel combination therapy. J Transl Med 2014; 12:101. [PMID: 24742198 PMCID: PMC4234320 DOI: 10.1186/1479-5876-12-101] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2013] [Accepted: 03/31/2014] [Indexed: 12/21/2022] Open
Abstract
Objective We tested the hypothesis that clopidogrel and cilostazol combination therapy could effectively attenuate systemic inflammatory reaction, facilitate proliferation of circulating endothelial progenitor cell (EPC), and improve the clinical outcomes of critical limb ischemia (CLI) in patients unsuitable for surgical revascularization or percutaneous transluminal angioplasty (PTA). Methods A total 55 patients (mean age, 72 years; 56% female) were consecutively enrolled. Clopidogrel and cilostazol combination therapy was administered throughout the study period. Results As compared with the baseline, circulating endothelial progenitor cell level (as shown by flow cytometry) was significantly increased (p < 0.003), whereas the CLI-related ulcers and painfulness were significantly improved (all p < 0.01) by day 90 after treatment. On the other hand, after clopidogrel and cilostazol combination therapy, galectin-3 level, lipoprotein-associated phospholipase A2 gene expression, and RhoA/ROCK-related protein expression in peripheral blood mononuclear cells were significantly suppressed (all p < 0.01). Eventually, by day 90, 5 patients (9.1%) died of other etiologies, 3 (5.5%) withdrew from the study, 6 (10.9%) required amputation, and the remaining 41 had satisfactory clinical improvement with complete wound healing in 9 (16.4%) patients. Conclusion The results of the present study highlight that clopidogrel and cilostazol combination therapy may be considered to be an alternative method for treating patients with CLI unsuitable for surgical revascularization or PTA.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | - Sheung-Fat Ko
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan.
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Maeda T, Takeuchi K, Xiaoling P, P Zankov D, Takashima N, Fujiyoshi A, Kadowaki T, Miura K, Ueshima H, Ogita H. Lipoprotein-associated phospholipase A2 regulates macrophage apoptosis via the Akt and caspase-7 pathways. J Atheroscler Thromb 2014; 21:839-53. [PMID: 24717759 DOI: 10.5551/jat.21386] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM Mutations in lipoprotein-associated phospholipase A2 (Lp-PLA2) are related to atherosclerosis. However, the molecular effects of Lp-PLA2 on atherosclerosis have not been fully investigated. Therefore, this study attempted to elucidate this issue. METHODS Monocytes were isolated from randomly selected healthy male volunteers according to each Lp-PLA2 genotype (wild-type Lp-PLA2 [Lp-PLA2 (V/V)], the heterozygous V279F mutation [LpPLA2 (V/F)] and the homozygous V279F mutation [Lp-PLA2 (F/F)]) and differentiated into macrophages. The level of apoptosis in the macrophages following incubation without serum was measured using the annexin V/propidium iodide double staining method, and the underlying mechanisms were further examined using a culture cell line. RESULTS The average plasma Lp-PLA2 concentration [Lp-PLA2 (V/V): 129.4 ng/mL, Lp-PLA2 (V/F): 70.7 ng/mL, Lp-PLA2 (F/F): 0.4 ng/mL] and activity [Lp-PLA2 (V/V): 164.3 nmol/min/mL, LpPLA2 (V/F): 100.9 nmol/min/mL, Lp-PLA2 (F/F): 11.6 nmol/min/mL] were significantly different between each genotype, although the basic clinical characteristics were similar. The percentage of apoptotic cells was significantly higher among the Lp-PLA2 (F/F) macrophages compared with that observed in the Lp-PLA2 (V/V) macrophages. This induction of apoptosis was independent of the actions of acetylated low-density lipoproteins. In addition, the transfection of the expression plasmid of V279F mutant Lp-PLA2 into Cos-7 cells or monocyte/macrophage-like U937 cells promoted apoptosis. The knockdown of Lp-PLA2 also increased the number of apoptotic cells. Among the cells expressing mutant Lp-PLA2, the caspase-7 activity was increased, while the activated Akt level was decreased. CONCLUSIONS The V279F mutation of Lp-PLA2 positively regulates the induction of apoptosis in macrophages and Cos-7 cells. An increase in the caspase-7 activity and a reduction in the activated Akt level are likely to be involved in this phenomenon.
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Affiliation(s)
- Toshinaga Maeda
- Division of Molecular Medical Biochemistry, Department of Biochemistry and Molecular Biology, Shiga University of Medical Science
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Feng LM, Feng GF, Chen Y. Evaluation of lipoprotein-associated phospholipase A2 in healthy Chinese Han adult serum. Lipids Health Dis 2014; 13:6. [PMID: 24393260 PMCID: PMC3895822 DOI: 10.1186/1476-511x-13-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/03/2014] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study is to establish lipoprotein-associated phospholipase A2 (Lp-PLA2) reference intervals (RIs) in healthy Chinese Han adults as a clinical diagnostic indicator according to the Clinical and Laboratory Standards Institute (CLSI) C28-A3 guidelines. Design and methods Lp-PLA2 levels in 763 healthy Chinese Han subjects (392 males and 371 females) were determined by colorimetric analysis and the central 95th percentile RIs were determined using non-parametric statistical methods. The correlations between serum Lp-PLA2 and blood markers were analyzed by Spearman correlation analyses. Results The Lp-PLA2 levels showed a Gaussian distribution with a statistically significant difference between females and males (t = 4.866, P < 0.001). The RIs of serum Lp-PLA2 were 194–640 U/L (18–49 years) and 208–698 U/L (50–88 years) for females, and 230–728 U/L for males. There was a positive correlation between Lp-PLA2 levels and age, Body Mass Index (BMI), as well as with levels of alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), total bilirubin (TBIL), triglyceride (TG), total cholesterol (Tch), low density lipoprotein cholesterol (LDL-c), apolipoprotein B (apoB), glucose (Glu), high sensitivity C reactive protein (Hs-CRP), white blood cell (WBC), hemoglobin (HGB) and red blood cell (RBC) (P < 0.05). A negative correlation was found with high density lipoprotein cholesterol (HDL-c) and Apolipoprotein AI (apoAI), and no correlation was found with platelet (Plt) levels. Conclusion Our results establish the RIs of serum Lp-PLA2 in healthy Chinese Han adults and demonstrate correlations between serum Lp-PLA2 and age, BMI, ALT, GGT, TBIL, TG, Tch, HDL-c, LDL-c, apoAI, apoB, Glu, Hs-CRP, WBC, RBC, and HGB levels.
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Affiliation(s)
| | | | - Yu Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, P,R, China.
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Tellis CC, Moutzouri E, Elisaf M, Wolfert RL, Tselepis AD. The elevation of apoB in hypercholesterolemic patients is primarily attributed to the relative increase of apoB/Lp-PLA₂. J Lipid Res 2013; 54:3394-402. [PMID: 24092915 DOI: 10.1194/jlr.m041806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a risk factor of cardiovascular disease. Plasma Lp-PLA₂ is mainly associated with apolipoprotein (apo)B-containing lipoproteins, primarily with low density lipoproteins (LDLs). Importantly, only a proportion of circulating lipoproteins contain Lp-PLA₂. We determined the plasma levels of Lp-PLA₂-bound apoB (apoB/Lp-PLA₂) in patients with primary hypercholesterolemia. The effect of simvastatin therapy was also addressed. The plasma apoB/Lp-PLA₂ concentration in 50 normolipidemic controls and 53 patients with primary hypercholesterolemia at baseline and at 3 months posttreatment with simvastatin (40 mg/day) was determined by an enzyme-linked immunosorbent assay. The concentration of the apoB-containing lipoproteins that do not bind Lp-PLA₂ [apoB/Lp-PLA₂⁻] was calculated by subtracting the apoB/Lp-PLA₂ from total apoB. The apoB/Lp-PLA₂ levels were 3.6-fold higher, while apoB/Lp-PLA₂⁻ were 1.3-fold higher in patients compared with controls. After 3 months of simvastatin treatment apoB/Lp-PLA₂ and apoB/Lp-PLA₂⁻ levels were reduced by 52% and 33%, respectively. The elevation in apoB-containing lipoproteins in hypercholesterolemic patients is mainly attributed to the relative increase in the proatherogenic apoB/Lp-PLA₂, while simvastatin reduces these particles to a higher extent compared with apoB/Lp-PLA₂⁻. Considering that Lp-PLA₂ is proatherogenic, the predominance of apoB/Lp-PLA₂ particles in hypercholesterolemic patients may contribute to their higher atherogenicity and incidence of cardiovascular disease.
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Affiliation(s)
- Constantinos C Tellis
- Laboratory of Biochemistry, Department of Chemistry University of Ioannina, Ioannina, Greece
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Paricalcitol effects on activities and metabolism of platelet activating factor and on inflammatory cytokines in hemodialysis patients. Int J Artif Organs 2013; 36:87-96. [PMID: 23335378 DOI: 10.5301/ijao.5000187] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/14/2012] [Indexed: 12/22/2022]
Abstract
PURPOSE Paricalcitol improves the inflammatory status of hemodialysis patients. PAF is a strong inflammatory mediator which is produced during hemodialysis. We studied the effects of paricalcitol on PAF and other inflammatory mediators implicated in chronic kidney disease (CKD). METHODS We examined the in vitro effects of paricalcitol on PAF/thrombin-induced aggregation as well as on the activities of PAF-basic metabolic enzymes, lyso-PAF acetyltransferase (Lyso-PAF-AT), DTT-insensitive CDP-choline: 1-alkyl-2-acetyl-sn-glycerol cholinephospho-transferase (PAF-CPT) and PAF-acetylhydrolase (PAF-AH) in blood cells from healthy volunteers. In addition, the in vivo effects of paricalcitol on the above these enzymes were examined in plasma and blood cells of hemodialysis patients who had not received any type of vitamin D treatment during the last three months before and after receiving paricalcitol for a month. Finally, IL-12p70, IL-1β, IL-6, IL-8 and TNF-α were measured. RESULTS Paricalcitol inhibited in vitro PAF/thrombin-induced platelet aggregation and the inhibitory effect was comparable with that of PAF/thrombin antagonists. In addition, paricalcitol inhibited in vitro PAF-CPT activity in platelets and leukocytes and increased PAF-AH activity in leukocytes, while much higher concentrations of paricalcitol were needed to inhibit Lyso-PAF-AT activity. Similarly, in hemodialysis patients, paricalcitol treatment reduced PAF-CPT activity in platelets and leukocytes and increased PAF-AH activity in leukocytes, while it could not influence Lyso-PAF-AT activity. On the other hand, paricalcitol therapy reduced IL-8, IL-1β, and TNF-α. CONCLUSIONS These results further support the beneficial effects of vitamin D treatment in hemodialysis patients, since it strongly affects PAF/thrombin activities, PAF-metabolism, and IL-8, IL-1β and TNF-α circulating levels.
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Mazereeuw G, Herrmann N, Bennett SAL, Swardfager W, Xu H, Valenzuela N, Fai S, Lanctôt KL. Platelet activating factors in depression and coronary artery disease: a potential biomarker related to inflammatory mechanisms and neurodegeneration. Neurosci Biobehav Rev 2013; 37:1611-21. [PMID: 23800745 DOI: 10.1016/j.neubiorev.2013.06.010] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2013] [Revised: 05/07/2013] [Accepted: 06/13/2013] [Indexed: 02/02/2023]
Abstract
The persistence of a depressive episode in coronary artery disease (CAD) patients not only heightens the risk of acute ischemic events, but it is also associated with accelerated cognitive decline. Antidepressant interventions for depression in CAD have only modest effects and novel approaches are limited by a poor understanding of etiological mechanisms. This review proposes that the platelet activating factor (PAF) family of lipids might be associated with the persistence of a depressive episode and related neurodegenerative pathology in CAD due to their association with leading etiological mechanisms for depression in CAD such as inflammation, oxidative and nitrosative stress, vascular endothelial dysfunction, and platelet reactivity. The evidence implicating PAFs in CAD, vascular pathology, and neurodegenerative processes is also presented. We also propose future directions for the investigation of PAFs as mediators of persistent depression. In summary, PAFs are implicated in leading mechanisms associated with depression in CAD. PAFs may therefore be associated with the persistence of depression in CAD and related to neurodegenerative and cognitive sequelae.
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Affiliation(s)
- Graham Mazereeuw
- Sunnybrook Research Institute, Toronto, Ontario, Canada; Department of Pharmacology and Toxicology, University of Toronto, Toronto, Ontario, Canada; Neural Regeneration Laboratory, Ottawa Institute of Systems Biology, Department of Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada; CIHR Training Program in Neurodegenerative Lipidomics, Canada
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Lipoprotein-associated phospholipase A2 activity predicts cardiovascular events in high risk coronary artery disease patients. PLoS One 2012; 7:e48171. [PMID: 23118945 PMCID: PMC3485195 DOI: 10.1371/journal.pone.0048171] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2012] [Accepted: 09/21/2012] [Indexed: 01/03/2023] Open
Abstract
Objective Lipoprotein-associated phospholipase A2 (Lp-PLA2) is deemed to play a role in atherosclerosis and plaque destabilization as demonstrated in animal models and in prospective clinical studies. However, most of the literature is either focused on high-risk, apparently healthy patients, or is based on cross sectional studies. Therefore, we tested the hypothesis that serum Lp-PLA2 mass and activity are useful for predicting cardiovascular (CV) events over the coronary atherosclerotic burden and conventional risk factors in high-risk coronary artery disease patients. Methods and Results In a prospective cohort study of 712 Caucasian patients, who underwent coronary angiography and measurement of both Lp-PLA2 mass and activity at baseline, we determined incident CV events at follow-up after splitting the patients into a high and a low Lp-PLA2 mass and activity groups based on ROC analysis and Youden index. Kaplan-Meier and propensity score matching analysis were used to compare CV event-free survival between groups. Follow-up data were obtained in 75% of the cohort after a median of 7.2 years (range 1–12.7 years) during which 129 (25.5%) CV events were observed. The high Lp-PLA2 activity patients showed worse CV event-free survival (66.7% vs. 79.5%, p = 0.023) and acute coronary syndrome-free survival (75.4% vs. 85.6%, p = 0.04) than those in low Lp-PLA2 group. Conclusions A high Lp-PLA2 activity implies a worse CV prognosis at long term follow up in high-risk Caucasian patients referred for coronary angiography.
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Lipoprotein-associated phospholipase A(2) bound on high-density lipoprotein is associated with lower risk for cardiac death in stable coronary artery disease patients: a 3-year follow-up. J Am Coll Cardiol 2012; 60:2053-60. [PMID: 23083783 DOI: 10.1016/j.jacc.2012.06.057] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/12/2012] [Accepted: 06/19/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to examine the prognostic value of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) associated with high-density lipoprotein (HDL) (HDL-Lp-PLA(2)) in patients with stable coronary artery disease (CAD). BACKGROUND Lp-PLA(2) is a novel risk factor for cardiovascular disease. It has been postulated that the role of Lp-PLA(2) in atherosclerosis may depend on the type of lipoprotein with which it is associated. METHODS Total plasma Lp-PLA(2) and HDL-Lp-PLA(2) mass and activity, lipids, and C-reactive protein were measured in 524 consecutive patients with stable CAD who were followed for a median of 34 months. The primary endpoint was cardiac death, and the secondary endpoint was hospitalization for acute coronary syndromes, myocardial revascularization, arrhythmic event, or stroke. RESULTS Follow-up data were obtained from 477 patients. One hundred twenty-three patients (25.8%) presented with cardiovascular events (24 cardiac deaths, 47 acute coronary syndromes, 28 revascularizations, 22 arrhythmic events, and 2 strokes). Total plasma Lp-PLA(2) mass and activity were predictors of cardiac death (hazard ratio [HR]: 1.013; 95% confidence interval [CI]: 1.005 to 1.021; p = 0.002; and HR: 1.040; 95% CI: 1.005 to 1.076; p = 0.025, respectively) after adjustment for traditional risk factors for CAD. In contrast, HDL-Lp-PLA(2) mass and activity were associated with lower risk for cardiac death (HR: 0.972; 95% CI: 0.952 to 0.993; p = 0.010; and HR: 0.689; 95% CI: 0.496 to 0.957; p = 0.026, respectively) after adjustment for traditional risk factors for CAD. CONCLUSIONS Total plasma Lp-PLA(2) is a predictor of cardiac death, while HDL-Lp-PLA(2) is associated with lower risk for cardiac death in patients with stable CAD, independently of other traditional cardiovascular risk factors.
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Ikonomidis I, Michalakeas CA, Parissis J, Paraskevaidis I, Ntai K, Papadakis I, Anastasiou-Nana M, Lekakis J. Inflammatory markers in coronary artery disease. Biofactors 2012; 38:320-8. [PMID: 22628054 DOI: 10.1002/biof.1024] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2012] [Accepted: 04/18/2012] [Indexed: 12/20/2022]
Abstract
Coronary artery disease (CAD) is one of the most common manifestations of atherosclerosis. Inflammation is considered one of the major processes that contribute to atherogenesis. Inflammation plays an important role not only on the initiation and progression of atherosclerosis but also on plaque rupture, an event that leads to acute vascular events. Various biomarkers express different pathways and pathophysiologic mechanisms of cardiovascular disease, and inflammatory biomarkers express different parts of the atherogenic process, regarding the initiation and progression of atherosclerosis or the destabilization of the atherosclerotic plaque. Therefore, inflammatory biomarkers may prove to be useful in the detection, staging, and prognosis of patients with CAD. Furthermore, the fact that inflammatory processes are essential steps in the course of the disease offers future therapeutic targets for the interruption of the atherogenic process or for the management of acute events.
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Affiliation(s)
- Ignatios Ikonomidis
- 2nd Cardiology Department, University of Athens, Attikon Hospital, Athens, Greece.
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Dohi T, Miyauchi K, Ohkawa R, Nakamura K, Thuboi S, Ogita M, Miyazaki T, Nishino A, Yokoyama K, Kurata T, Yatomi Y, Daida H. Higher lipoprotein-associated phospholipase A2 levels are associated with coronary atherosclerosis documented by coronary angiography. Ann Clin Biochem 2012; 49:527-33. [PMID: 22933444 DOI: 10.1258/acb.2012.011252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been proposed as an inflammatory marker of cardiovascular disease. The present study investigates associations between Lp-PLA2 and other important biomarkers in Japanese patients with coronary artery disease. METHODS We measured Lp-PLA2 levels in 141 consecutive patients (age 62.6 ± 3.8 years; men 69.2%) with angiographic evidence of coronary artery disease (acute coronary syndrome [ACS]; n = 38), stable angina pectoris (SAP; n = 72) or with angiographically normal coronary arteries (NCA; n = 31). RESULTS Levels of Lp-PLA2 significantly correlated with low-density lipoprotein-cholesterol (r = 0.302), homocysteine (r = 0.528) and paraoxonase (r = 0.401) in all patients (all P < 0.01). Levels of Lp-PLA2 were significantly higher in patients with coronary atherosclerosis (ACS and SAP) than with NCA (P < 0.05). Levels of highly sensitive C-reactive protein were significantly higher in patients with ACS than with SAP and NCA (both P < 0.05). Multivariate logistic regression analyses revealed that higher Lp-PLA2 levels were independently associated with coronary atherosclerosis (odds ratio: 1.058; 95% confidence interval: 1.012-1.121; P = 0.001). CONCLUSIONS Higher Lp-PLA2 levels are associated with coronary atherosclerosis independently of traditional coronary risk factors. Thus, Lp-PLA2 is a novel biomarker of coronary atherosclerosis in Japanese patients.
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Affiliation(s)
- Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Tokyo 113-0033, Japan.
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Abstract
Although an atherogenic lipoprotein phenotype has been well recognized as an important predictor of cardiovascular disease, recent studies have demonstrated a number of additional lipid-related markers as emerging biomarkers to identify patients at risk for future coronary heart disease. Among them, lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), seems to be a promising candidate that might be added to the clinical armamentarium for improved prediction of cardiovascular disease in the future. Of particular note, Lp-PLA(2) is the only enzyme that cleaves oxidized low-density lipoprotein (oxLDL) in the subendothelial space, with further generation of proinflammatory mediators such as lysophosphatidylcholine (LysoPC) and oxidized fatty acid (oxFA), thereby probably linking two important features of atherogenesis, namely oxidation of LDL and local inflammatory processes within the atherosclerotic plaque. This overview aims to summarize our current knowledge based on observations from recent experimental and clinical studies. Emphasis has been put on potential pathophysiological mechanisms of action and on the clinical relevance of Lp-PLA(2) in a wide variety of clinical settings, including apparently healthy individuals, patients with stable angina or acute coronary syndromes, after myocardial infarction, and with subclinical disease. Although a growing body of evidence from epidemiological and clinical studies suggests that Lp-PLA(2) may represent an independent and clinically relevant long-term risk marker for coronary heart disease and, probably, also for stroke, the role of this enzyme in the setting of the acute coronary syndrome remains to be established.
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Affiliation(s)
- Natalie Khuseyinova
- Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Ulm, Germany
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Tsai TH, Chen YL, Lin HS, Liu CF, Chang HW, Lu CH, Chang WN, Chen SF, Wu CJ, Leu S, Ko SF, Yip HK. Link between lipoprotein-associated phospholipase A2 gene expression of peripheral-blood mononuclear cells and prognostic outcome after acute ischemic stroke. J Atheroscler Thromb 2012; 19:523-31. [PMID: 22447189 DOI: 10.5551/jat.10751] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
AIM To evaluate the potential of the lipoprotein-associated phospholipase A(2) (Lp-PLA(2) level as a biomarker in the prediction of prognostic outcome in patients with acute ischemic stroke (IS). METHODS From October 2008 to March 2010, 130 patients with acute IS were prospectively enrolled in the study and their medical records were reviewed. A blood sample was collected from each patient 48 hours after acute IS, as well as from 20 healthy volunteers as controls. Messenger-RNA (mRNA) expression of Lp-PLA(2) of peripheral-blood mononuclear cells (PBMNCs) relative to that of β actin was measured using quantitative reverse transcription polymerase chain reaction (RT-PCR). RESULTS Patients with acute IS exhibited significantly higher Lp-PLA(2) mRNA expression of PBMNCs than the control group (p <0.0001). Lp-PLA(2) mRNA expression of PBMNCs in patients with a major adverse clinical outcome (MACO) (defined as recurrent stroke or death) within 90 days was significantly higher than in patients without MACO (p=0.006). Furthermore, elevated Lp-PLA(2) mRNA expression was strongly associated with old age, diabetes mellitus, a positive history of significant coronary arterial disease and significant stenosis of the extra-cranial carotid arteries (all p <0.04), and positively correlated with the body mass index, leukocyte count, and serum levels of total cholesterol and low-density lipoprotein cholesterol. Multivariate analysis revealed that Lp-PLA(2) mRNA expression of PBMNCs was a significant independent predictor of MACO within 90 days (p= 0.011). CONCLUSION Elevated Lp-PLA(2) mRNA expression of PBMNCs seems to be a potential biomarker for predicting an unfavorable outcome in patients with acute IS.
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Affiliation(s)
- Tzu-Hsien Tsai
- Division of Cardiology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan
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Vittos O, Toana B, Vittos A, Moldoveanu E. Lipoprotein-associated phospholipase A2 (Lp-PLA2): a review of its role and significance as a cardiovascular biomarker. Biomarkers 2012; 17:289-302. [PMID: 22401038 DOI: 10.3109/1354750x.2012.664170] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To conduct a comprehensive, systematic review of studies assessing the significance of lipoprotein-associated phospholipase A2 in cardiovascular diseases (CVDs). MATERIAL AND METHODS A review of the literature was performed using the search term "Lipoprotein-associated phospholipase A2 (Lp-PLA2)" and each of the following terms: "cardiovascular risk," "cardiovascular death," "atherosclerotic disease," "coronary events," "transient ischemic attack (TIA)," "stroke," and "heart failure." The searches were performed on Medline, Google Scholar and ClinicalTrials.gov. RESULTS The majority of published studies showed a significant association between Lp-PLA2 levels and cardiovascular events after multivariate adjustment. The association was consistent across a wide variety of subjects of both sexes and different ethnic backgrounds. CONCLUSIONS The role of Lp-PLA2 as a significant biomarker of vascular inflammation was confirmed, and Lp-PLA2 seems to be closely correlated to cardiovascular events. It may be an important therapeutic target and may have an important role in prevention, risk stratification and personalised medicine.
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Paik JK, Kim JY, Kim OY, Lee Y, Jeong TS, Sweeney G, Jang Y, Lee JH. Circulating and PBMC Lp-PLA2 associate differently with oxidative stress and subclinical inflammation in nonobese women (menopausal status). PLoS One 2012; 7:e29675. [PMID: 22359537 PMCID: PMC3281008 DOI: 10.1371/journal.pone.0029675] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 12/02/2011] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND This study aimed to determine the association of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity in circulation and peripheral blood mononuclear cells (PBMCs) with inflammatory and oxidative stress markers in nonobese women and according to menopausal status. Lp-PLA(2) activity, a marker for cardiovascular risk is associated with inflammation and oxidative stress. METHODOLOGY/PRINCIPAL FINDINGS Eighty postmenopausal women (53.0±4.05 yr) and 96 premenopausal women (39.7±9.25 yr) participated in this study. Lp-PLA(2) activities, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β in plasma as well as in PBMCs were measured. Plasma ox-LDL was also measured. Postmenopausal women demonstrated higher circulating levels of ox-LDL and IL-6, as well as IL-6, TNF-α, and IL-1β in PBMCs, than premenopausal women. In both groups, plasma Lp-PLA(2) activity positively correlated with Lp-PLA(2) activity in PBMCs and plasma ox-LDL. In premenopausal women, Lp-PLA(2) activities in plasma and PBMCs positively correlated with IL-6, TNF-α, and IL-1β in PBMCs. In postmenopausal women, plasma ox-LDL positively correlated with PBMC cytokine production. In subgroup analysis of postmenopausal women according to plasma ox-LDL level (median level: 48.715 U/L), a significant increase in Lp-PLA(2) activity in the plasma but not the PBMCs was found in the high ox-LDL subgroup. Plasma Lp-PLA(2) activity positively correlated with unstimulated PBMC Lp-PLA(2) activity in the low ox-LDL subgroup (r = 0.627, P<0.001), whereas in the high ox-LDL circulating Lp-PLA(2) activity positively correlated with plasma ox-LDL (r = 0.390, P = 0.014) but not with Lp-PLA(2) activity in PBMCs. CONCLUSIONS/SIGNIFICANCE The lack of relation between circulating Lp-PLA(2) activity and Lp-PLA(2) activity in PBMCs was found in postmenopausal women with high ox-LDL. This may indicate other sources of circulating Lp-PLA(2) activity except PBMC in postmenopausal women with high ox-LDL. We also demonstrated that circulating Lp-PLA(2) and PBMC secreted Lp-PLA(2) associate differently with markers of oxidative stress and sub clinical inflammation in nonobese women, particularly according to the menopausal states.
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Affiliation(s)
- Jean Kyung Paik
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Ji Young Kim
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Oh Yoen Kim
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Yonghee Lee
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Tae-Sook Jeong
- National Research Laboratory of Lipid Metabolism and Atherosclerosis, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Gary Sweeney
- Institut Pasteur Korea, Seoul, Korea & Department of Biology, York University, Toronto, Canada
| | - Yangsoo Jang
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- Cardiology Division, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Genome Center, Yonsei University College of Medicine, Seoul, Korea
- Severance Medical Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Ho Lee
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
- * E-mail:
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Colak Y, Senates E, Ozturk O, Doganay HL, Coskunpinar E, Oltulu YM, Eren A, Sahin O, Ozkanli S, Enc FY, Ulasoglu C, Tuncer I. Association of serum lipoprotein-associated phospholipase A2 level with nonalcoholic fatty liver disease. Metab Syndr Relat Disord 2011; 10:103-9. [PMID: 22112193 DOI: 10.1089/met.2011.0111] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
BACKGROUND Nonalcoholic fatty liver disease (NAFLD) is the hepatic manifestation of metabolic syndrome and is one of the most common causes of chronic liver disease, worldwide. Lipoprotein-associated phospholipase A2 (Lp-PLA2) was recently characterized as a novel inflammatory biomarker that is correlated with several components constituting the metabolic syndrome. METHODS In this study, we determined the serum levels of Lp-PLA2 in patients with definite nonalcoholic steatohepatitis (NASH, n=25), borderline NASH (n=22), simple fatty liver (n=10), and healthy controls without evidence of liver disease (n=38). The levels of Lp-PLA2 were measured by enzyme-linked immunosorbent assay and compared in the four study groups. Moreover, concentrations of Lp-PLA2 were assessed in relation to the general characteristics of the study participants and the results of liver biopsy. RESULTS Concentrations of Lp-PLA2 were significantly higher in patients with definite NASH (161.8±0.9 μg/L, P<0.001), borderline NASH (135.4±47.7 μg/L, P=0.001), and simple fatty liver (132.4±46.2 μg/L, P=0.042) compared with healthy controls (86.2±40.7 μg/L). Furthermore, the serum Lp-PLA2 level was strongly associated to histological steatosis scores in patients with NAFLD (β=0.32, t=2.50, P=0.016). CONCLUSION Although subject to future confirmation, our data suggest that Lp-PLA2 levels are elevated in NAFLD.
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Affiliation(s)
- Yasar Colak
- Department of Gastroenterology, Istanbul Goztepe Education and Research Hospital, Istanbul, Turkey.
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Liu YS, Hu XB, Li HZ, Jiang WD, Wang X, Lin H, Qin AQ, Wang YM, Zhao T, Dong ZQ, Zhang M, Lu QH. Association of lipoprotein-associated phospholipase A₂ with characteristics of vulnerable coronary atherosclerotic plaques. Yonsei Med J 2011; 52:914-22. [PMID: 22028154 PMCID: PMC3220251 DOI: 10.3349/ymj.2011.52.6.914] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/05/2023] Open
Abstract
PURPOSE Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is an inflammatory enzyme expressed in atherosclerotic plaques. We investigated the association of circulating Lp-PLA₂ with characteristics of vulnerable coronary atherosclerotic plaques. MATERIALS AND METHODS We recruited 113 patients with either unstable angina (UA, n=59) and stable angina (SA, n=54) by coronary angiography. Thirty-six healthy subjects served as controls. Intravascular ultrasound (IVUS) was used to evaluate the characteristics of coronary atherosclerotic plaque, and serum Lp-PLA₂ concentration was measured as well. RESULTS Lp-PLA₂ concentration was significantly higher in both UA and SA patients [(396±36) μg/L and (321±39) μg/L, respectively] compared with the controls [(127 ± 49) μg/L, p<0.01], and higher in UA than SA group. IVUS findings showed that remodeling index (RI) (0.91 ± 0.15 vs. 0.85 ± 0.11, p=0.005) and eccentricity index (EI) (0.73 ± 0.16 vs. 0.65 ± 0.22, p=0.039) were larger in UA than in SA group, and fibrous caps were thicker in SA than UA group [(0.91 ± 0.23) mm vs. (0.63 ± 0.21) mm, p=0.032]. Moreover, Lp-PLA₂ correlated positively with EI (r=0.439, p<0.01) and RI (r=0.592, p<0.05) in UA group. There was an inverse relationship between Lp-PLA₂ and fibrous cap thickness in both UA (r=-0.587, p<0.001) and SA (r=-0.318, p<0.05) groups. The independent risk factors in UA group were Lp-PLA₂ (OR=1.055, 95% CI: 1.03-1.08, p=0.013), LDL-cholesterol (OR=0.032, 95% CI: 0.00-0.05, p=0.041) and fibrous cap thickness (OR=0.008, 95% CI: 0.00-0.45, p=0.019). Lp-PLA₂ was strongly associated with both EI and fibrous cap thickness in both groups. CONCLUSION Serum level of Lp-PLA₂ is associated with both eccentricity index and fibrous cap thickness in both UA and SA groups. Elevated levels of circulating Lp-PLA₂ might to be a strong risk factor and more serious for unstable angina than stable angina.
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Affiliation(s)
- Yu-Sheng Liu
- Department of Cardiology, The Qilu Hospital of Shandong University, Jinan, China
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Xiao-Bo Hu
- Department of Cardiology, The Qilu Hospital of Shandong University, Jinan, China
| | - Hong-Zhuan Li
- Division of Internal Medicine, The NO. 4th Hospital of Jinan City, Taishan Medical College, Jinan, China
| | - Wei-Dong Jiang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Xin Wang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Hao Lin
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Ai-Qiong Qin
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Yong-Mei Wang
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Tong Zhao
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Zhao-Qiang Dong
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
| | - Mei Zhang
- Department of Cardiology, The Qilu Hospital of Shandong University, Jinan, China
| | - Qing-Hua Lu
- Department of Cardiology, The Second Hospital of Shandong University, Jinan, China
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O'Donoghue ML, Braunwald E, White HD, Serruys P, Steg PG, Hochman J, Maggioni AP, Bode C, Weaver D, Johnson JL, Cicconetti G, Lukas MA, Tarka E, Cannon CP. Study design and rationale for the Stabilization of pLaques usIng Darapladib-Thrombolysis in Myocardial Infarction (SOLID-TIMI 52) trial in patients after an acute coronary syndrome. Am Heart J 2011; 162:613-619.e1. [PMID: 21982651 DOI: 10.1016/j.ahj.2011.07.018] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Accepted: 07/26/2011] [Indexed: 10/17/2022]
Abstract
BACKGROUND Higher levels of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) are associated with a higher risk of cardiovascular events and may play a causal role in atherogenesis. Darapladib inhibits Lp-PLA(2) activity in plasma and in arterial plaques and may confer clinical benefit in preventing cardiovascular events. STUDY DESIGN The SOLID-TIMI 52 trial is a randomized, double-blind, placebo-controlled, multicenter, event-driven trial. Approximately 13,000 subjects are being randomized to darapladib (160 mg enteric-coated tablet daily) or matching placebo within 30 days of hospitalization with an acute coronary syndrome. The primary end point is the composite of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Secondary end points include major and total coronary events, individual components of the primary end point, and all-cause mortality. The study will continue until approximately 1,500 primary end point events have occurred to achieve 90% power to detect a 15.5% reduction in the primary end point. The median treatment duration is anticipated to be approximately 3 years, with a total study duration of approximately 4.1 years. CONCLUSIONS The SOLID-TIMI 52 trial will determine the clinical benefit of direct inhibition of Lp-PLA(2) activity with darapladib in patients after an acute coronary syndrome.
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Do Atherosclerosis and Obesity-Associated Susceptibility to Cancer Share Causative Link to oxLDL and LOX-1? Cardiovasc Drugs Ther 2011; 25:477-87. [DOI: 10.1007/s10557-011-6330-8] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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Howard KM, Abdel-Al M, Ditmyer M, Patel N. Lipopolysaccharide and platelet-activating factor stimulate expression of platelet-activating factor acetylhydrolase via distinct signaling pathways. Inflamm Res 2011; 60:735-44. [PMID: 21432021 DOI: 10.1007/s00011-011-0326-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2010] [Revised: 02/22/2011] [Accepted: 03/03/2011] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVES This study was designed to investigate and characterize the ability of platelet-activating factor (PAF) to induce the expression of platelet-activating factor acetylhydrolase (PAF-AH). METHODS Ribonuclease protection assays and quantitative real-time PCR were used to investigate the ability of lipopolysaccharide (LPS) and PAF to regulate PAF-AH mRNA expression in human monocyte-macrophage 6 (MM6) cells. Pharmacological inhibitors of mitogen activated protein kinases (MAPK) and PAF receptor antagonists were used to investigate the mechanism of regulation of PAF-AH. RESULTS PAF-AH mRNA levels were increased upon exposure to LPS or PAF in a dose-dependent manner. LPS elicited a more potent and rapid increase in PAF-AH expression than the PAF-stimulated response. However, when administered concomitantly, PAF augmented the LPS-stimulated response. LPS-stimulated PAF-AH expression was susceptible to partial inhibition by a p38 MAPK inhibitor and PAF receptor antagonists. PAF-induced up-regulation of PAF-AH levels was solely mediated via the PAF receptor and was p38 MAPK-independent. CONCLUSION The proinflammatory mediators, LPS and PAF, increased levels of PAF-AH mRNA via distinct signaling pathways.
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Affiliation(s)
- Katherine M Howard
- Department of Biomedical Sciences, University of Nevada Las Vegas School of Dental Medicine, 1001 Shadow Lane, Las Vegas, Nevada 89106, USA.
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Stewart RAH, White HD. The Role of Lipoprotein-Associated Phospholipase A2 as a Marker and Potential Therapeutic Target in Atherosclerosis. Curr Atheroscler Rep 2011; 13:132-7. [DOI: 10.1007/s11883-010-0158-8] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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White H. Darapladib and its potential for plaque stabilization and prevention of cardiac events. ACTA ACUST UNITED AC 2010. [DOI: 10.2217/clp.10.45] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Tselepis AD, Hahalis G, Tellis CC, Papavasiliou EC, Mylona PT, Kourakli A, Alexopoulos DC. Plasma levels of lipoprotein-associated phospholipase A(2) are increased in patients with β-thalassemia. J Lipid Res 2010; 51:3331-41. [PMID: 20625038 DOI: 10.1194/jlr.m007229] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is an independent cardiovascular risk factor. We investigated the plasma levels of Lp-PLA(2) activity and mass as a function of plasma lipid levels, LDL subclass profile, and oxidative stress in patients with β-thalassemia. Thirty-five patients with β-thalassemia major (β-TM) and 25 patients with β-thalassemia intermedia (β-TI) participated in the study. Lp-PLA(2) activity and mass were measured in total plasma, in apolipoprotein (apo)B-depleted plasma (HDL-Lp-PLA(2)), and in LDL subclasses. Lp-PLA(2) activity produced and secreted from peripheral blood monocytes in culture was also determined. Patients with β-thalassemia are characterized by a predominance of small-dense LDL particles, increased oxidative stress, and very high plasma levels of Lp-PLA(2) mass and activity, despite low LDL-cholesterol levels. A significant positive correlation between plasma Lp-PLA(2) activity or mass and 8-isoprostane (8-epiPGF2a) and ferritin levels as well as intima-media thickness (IMT) values was observed. An increase in secreted and cell-associated Lp-PLA(2) activity from monocytes in culture was observed in both patient groups. The HDL-Lp-PLA(2) activity and mass as well as the ratio of HDL-Lp-PLA(2)/plasma Lp-PLA(2) were significantly higher in both patient groups compared with the control group. In conclusion, patients with β-thalassemia exhibit high plasma Lp-PLA(2) levels, attributed to increased enzyme secretion from monocytes/macrophages and to the predominance of sdLDL particles in plasma. Plasma Lp-PLA(2) is correlated with carotid IMT, suggesting that this enzyme may be implicated in premature carotid atherosclerosis observed in β-thalassemia.
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Association of carotid plaque Lp-PLA(2) with macrophages and Chlamydia pneumoniae infection among patients at risk for stroke. PLoS One 2010; 5:e11026. [PMID: 20543948 PMCID: PMC2882946 DOI: 10.1371/journal.pone.0011026] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2010] [Accepted: 05/11/2010] [Indexed: 11/20/2022] Open
Abstract
Background We previously showed that the burden of Chlamydia pneumoniae in carotid plaques was significantly associated with plaque interleukin (IL)-6, and serum IL-6 and C-reactive protein (CRP), suggesting that infected plaques contribute to systemic inflammatory markers in patients with stroke risk. Since lipoprotein-associated phospholipase A2 (Lp-PLA2) mediates inflammation in atherosclerosis, we hypothesized that serum Lp-PLA2 mass and activity levels and plaque Lp-PLA2 may be influenced by plaque C. pneumoniae infection. Methodology/Principal Findings Forty-two patients underwent elective carotid endarterectomy. Tissue obtained at surgery was stained by immunohistochemistry for Lp-PLA2 grade, macrophages, IL-6, C. pneumoniae and CD4+ and CD8+ cells. Serum Lp-PLA2 activity and mass were measured using the colorimetric activity method (CAM™) and ELISA, respectively. Serum homocysteine levels were measured by HPLC. Eleven (26.2%) patients were symptomatic with transient ischemic attacks. There was no correlation between patient risk factors (smoking, coronary artery disease, elevated cholesterol, diabetes, obesity, hypertension and family history of genetic disorders) for atherosclerosis and serum levels or plaque grade for Lp-PLA2. Plaque Lp-PLA2 correlated with serum homocysteine levels (p = 0.013), plaque macrophages (p<0.01), and plaque C. pneumoniae (p<0.001), which predominantly infected macrophages, co-localizing with Lp-PLA2. Conclusions The significant association of plaque Lp-PLA2 with plaque macrophages and C. pneumoniae suggests an interactive role in accelerating inflammation in atherosclerosis. A possible mechanism for C. pneumoniae in the atherogenic process may involve infection of macrophages that induce Lp-PLA2 production leading to upregulation of inflammatory mediators in plaque tissue. Additional in vitro and in vivo research will be needed to advance our understanding of specific C. pneumoniae and Lp-PLA2 interactions in atherosclerosis.
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Extracellular phospholipases in atherosclerosis. Biochimie 2010; 92:594-600. [DOI: 10.1016/j.biochi.2010.02.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2009] [Accepted: 02/02/2010] [Indexed: 01/01/2023]
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Lp-PLA2 Inhibition-The Atherosclerosis Panacea? Pharmaceuticals (Basel) 2010; 3:1360-1373. [PMID: 27713307 PMCID: PMC4033986 DOI: 10.3390/ph3051360] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2010] [Accepted: 04/21/2010] [Indexed: 12/28/2022] Open
Abstract
Based on the complex pathophysiology of atherosclerosis, a large number of biomarkers that relate to lipids, inflammation, immunity, thrombosis and hemostasis, have been investigated experimentally, in epidemiologic studies and in clinical trials. Interest focuses on their potential role to aid in risk stratification, as possible surrogate markers of atherosclerosis, and potential targets for therapy. More recently, one lipid associated biomarker, lipoprotein-associated phospholipase A2 (Lp-PLA2), has gained considerable interest. In addition to a plausible pathophysiological role by generating pro-inflammatory and pro-atherogenic compounds from oxidized LDL in the vessel wall, there is a large, fairly consistent epidemiological database indicating that increased levels of Lp-PLA2 mass or activity are associated with increased risk for cardiovascular outcomes; such data further suggest that it might improve risk stratification. In addition, clinical studies indicate that increased Lp-PLA2 levels are associated with endothelial dysfunction. Moreover, it may also serve as an interesting therapeutic target, since a specific inhibitor of the enzyme is available with promising animal data and initial positive data in humans. Recent experimental data from a hyperlipidemic diabetic pig model strongly suggest that increased Lp-PLA2 in the vessel wall is associated with a more vulnerable plaque phenotype which can be modulated by inhibiting Lp-PLA2 activity. A biomarker study in more than 1,000 patients with CHD over three months has demonstrated a positive effect on various inflammatory molecules. In addition, an imaging study using IVUS based modalities (greyscale, virtual histology, and palpography) together with a panel of biomarkers (IBIS-2) has been done in more than 300 patients with CHD treated over 12 months and results indicate that the progression of the necrotic core of the plaque can be retarded. Inhibition of the pro-atherogenic and pro-inflammatory effects of Lp-PLA2 may therefore contribute to decrease the residual risk in high risk patients already on polypharmacotherapy. This hypothesis is now being tested in two large phase 3 clinical trials. Thus, Lp-PLA2 indeed may represent a biomarker and a promising target for intervention.
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Lipoprotein-Associated Phospholipase A2 and C-Reactive Protein for Measurement of Inflammatory Risk: Independent or Complementary? CURRENT CARDIOVASCULAR RISK REPORTS 2009. [DOI: 10.1007/s12170-009-0073-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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The role of lipoprotein-associated phospholipase A2 in atherosclerosis may depend on its lipoprotein carrier in plasma. Biochim Biophys Acta Mol Cell Biol Lipids 2009; 1791:327-38. [PMID: 19272461 DOI: 10.1016/j.bbalip.2009.02.015] [Citation(s) in RCA: 117] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2008] [Revised: 02/06/2009] [Accepted: 02/19/2009] [Indexed: 01/28/2023]
Abstract
Platelet-activating factor (PAF) acetylhydrolase exhibits a Ca(2+)-independent phospholipase A2 activity and degrades PAFas well as oxidized phospholipids (oxPL). Such phospholipids are accumulated in the artery wall and may play key roles in vascular inflammation and atherosclerosis. PAF-acetylhydrolase in plasma is complexed to lipoproteins; thus it is also referred to as lipoprotein-associated phospholipase A2 (Lp-PLA2). Lp-PLA2 is primarily associated with low-density lipoprotein (LDL), whereas a small proportion of circulating enzyme activity is also associated with high-density lipoprotein (HDL). The majority of the LDL-associated Lp-PLA2 (LDL-Lp-PLA2) activity is bound to atherogenic small-dense LDL particles and it is a potential marker of these particles in plasma. The distribution of Lp-PLA2 between LDL and HDL is altered in various types of dyslipidemias. It can be also influenced by the presence of lipoprotein (a) [Lp(a)] when plasma levels of this lipoprotein exceed 30 mg/dl. Several lines of evidence suggest that the role of plasma Lp-PLA2 in atherosclerosis may depend on the type of lipoprotein particle with which this enzyme is associated. In this regard, data from large Caucasian population studies have shown an independent association between the plasma Lp-PLA2 levels (which are mainly influenced by the levels of LDL-Lp-PLA2) and the risk of future cardiovascular events. On the contrary, several lines of evidence suggest that HDL-associated Lp-PLA2 may substantially contribute to the HDL antiatherogenic activities. Recent studies have provided evidence that oxPL are preferentially sequestered on Lp(a) thus subjected to degradation by the Lp(a)-associated Lp-PLA2. These data suggest that Lp(a) may be a potential scavenger of oxPL and provide new insights into the functional role of Lp(a) and the Lp(a)-associated Lp-PLA2 in normal physiology as well as in inflammation and atherosclerosis. The present review is focused on recent advances concerning the Lp-PLA2 structural characteristics, the molecular basis of the enzyme association with distinct lipoprotein subspecies, as well as the potential role of Lp-PLA2 associated with different lipoprotein classes in atherosclerosis and cardiovascular disease.
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