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Cefalù AB, Nardi E, Giammanco A, Gagliardo CM, Barbagallo CM, La Grutta L, Toia P, Brucato F, Scrimali C, Fasciana TMG, Spina R, Lanza M, Vitale F, Noto D, Averna M. Echocardiographic Calcium Score of Aortic Valve Correlates with Coronary Artery Calcium Score in Heterozygous Familial Hypercholesterolemia. Life (Basel) 2025; 15:506. [PMID: 40141850 PMCID: PMC11943964 DOI: 10.3390/life15030506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2025] [Revised: 03/14/2025] [Accepted: 03/18/2025] [Indexed: 03/28/2025] Open
Abstract
BACKGROUND Patients with heterozygous familial hypercholesterolemia (HeFH) are at a high risk of atherosclerotic cardiovascular disease. The coronary artery calcification (CAC) score by the Ct-scan Agatston calcium score (ACS) > 100 classifies FH at a higher risk. The echocardiographic calcium score (ECS) evaluates aortic valve calcifications and is considered a good predictor of the atherosclerotic burden and cardiovascular outcome. OBJECTIVE To test the ECS as a predictor of ACS > 100 in a HeFH cohort. METHODS A coronary calcium CT scan with the calculation of ACS and an at rest-transthoracic echocardiogram with ECS evaluation were performed in 81 HeFH patients. Patients were divided into two groups according to the ACS: high-risk ACS patients (High-ACS) with Agatston value > 100 and low risk ACS patients (Low-ACS) with Agatston value ≤ 100. Patients were stratified according to ECS = 0 or ECS > 0. RESULTS High-ACS patients were older than Low-ACS patients; BMI, waist circumference, and blood systolic pressure were significantly higher (p < 0.001) in High-ACS patients. The ECS predicted an ACS > 100 with sensitivity = 0.84, specificity = 0.89, accuracy = 0.86, and precision = 0.76. CONCLUSIONS The ECS could be a good surrogate of a coronary calcium CT scan for ACS evaluation in the specific subset of HeFH patients.
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Affiliation(s)
- Angelo Baldassare Cefalù
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Emilio Nardi
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Antonina Giammanco
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Carola Maria Gagliardo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Carlo Maria Barbagallo
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Ludovico La Grutta
- Section of Radiology, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (L.L.G.); (P.T.)
| | - Patrizia Toia
- Section of Radiology, Department of Biomedicine, Neurosciences and Advanced Diagnostics (BiND), University Hospital “Paolo Giaccone”, 90127 Palermo, Italy; (L.L.G.); (P.T.)
| | - Federica Brucato
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Chiara Scrimali
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Teresa Maria Grazia Fasciana
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Rossella Spina
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Marina Lanza
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Francesco Vitale
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Davide Noto
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
| | - Maurizio Averna
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties “G. D’Alessandro” (PROMISE), University of Palermo, Via del Vespro 129, 90127 Palermo, Italy; (A.B.C.); (E.N.); (A.G.); (C.M.G.); (C.M.B.); (F.B.); (C.S.); (T.M.G.F.); (R.S.); (M.L.); (F.V.)
- Institute of Biophysics (IBF), National Research Council (CNR), 90146 Palermo, Italy
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Pérez-Carrión MD, Posadas I, Ceña V. Nanoparticles and siRNA: A new era in therapeutics? Pharmacol Res 2024; 201:107102. [PMID: 38331236 DOI: 10.1016/j.phrs.2024.107102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 02/03/2024] [Accepted: 02/05/2024] [Indexed: 02/10/2024]
Abstract
Since its discovery in 1998, the use of small interfering RNA (siRNA) has been increasing in biomedical studies because of its ability to very selectively inhibit the expression of any target gene. Thus, siRNAs can be used to generate therapeutic compounds for different diseases, including those that are currently 'undruggable'. This has led siRNA-based therapeutic compounds to break into clinical settings, with them holding the promise to potentially revolutionise therapeutic approaches. To date, the United States Food and Drug Administration (FDA) have approved 5 compounds for treating different diseases including hypercholesterolemia, transthyretin-mediated amyloidosis (which leads to polyneuropathy), hepatic porphyria, and hyperoxaluria. This current article presents an overview of the molecular mechanisms involved in the selective pharmacological actions of siRNA-based compounds. It also describes the ongoing clinical trials of siRNA-based therapeutic compounds for hepatic diseases, pulmonary diseases, atherosclerosis, hypertriglyceridemia, transthyretin-mediated amyloidosis, and hyperoxaluria, kidney diseases, and haemophilia, as well as providing a description of FDA-approved siRNA therapies. Because of space constraints and to provide an otherwise comprehensive review, siRNA-based compounds applied to cancer therapies have been excluded. Finally, we discuss how the use of lipid-based nanoparticles to deliver siRNAs holds promise for selectively targeting mRNA-encoding proteins associated with the genesis of different diseases. Thus, siRNAs can help reduce the cellular levels of these proteins, thereby contributing to disease treatment. As consequence, a marked increase in the number of marketed siRNA-based medicines is expected in the next two decades, which will likely open up a new era of therapeutics.
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Affiliation(s)
- María Dolores Pérez-Carrión
- Unidad Asociada CSIC-UCLM Neurodeath. Instituto de Nanociencia Molecular (INAMOL). Universidad de Castilla-La Mancha, Albacete, Spain; CIBER, Instituto de Salud Carlos III, Madrid, Spain
| | - Inmaculada Posadas
- Unidad Asociada CSIC-UCLM Neurodeath. Instituto de Nanociencia Molecular (INAMOL). Universidad de Castilla-La Mancha, Albacete, Spain; CIBER, Instituto de Salud Carlos III, Madrid, Spain
| | - Valentín Ceña
- Unidad Asociada CSIC-UCLM Neurodeath. Instituto de Nanociencia Molecular (INAMOL). Universidad de Castilla-La Mancha, Albacete, Spain; CIBER, Instituto de Salud Carlos III, Madrid, Spain.
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Tada H, Kawashiri MA, Nohara A, Sekiya T, Watanabe A, Takamura M. Genetic Counseling and Genetic Testing for Familial Hypercholesterolemia. Genes (Basel) 2024; 15:297. [PMID: 38540356 PMCID: PMC10970256 DOI: 10.3390/genes15030297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 06/14/2024] Open
Abstract
Familial hypercholesterolemia (FH) is one of the most common autosomal codominant Mendelian diseases. The major complications of FH include tendon and cutaneous xanthomas and coronary artery disease (CAD) associated with a substantial elevation of serum low-density lipoprotein levels (LDL). Genetic counseling and genetic testing for FH is useful for its diagnosis, risk stratification, and motivation for further LDL-lowering treatments. In this study, we summarize the epidemiology of FH based on numerous genetic studies, including its pathogenic variants, genotype-phenotype correlation, prognostic factors, screening, and usefulness of genetic counseling and genetic testing. Due to the variety of treatments available for this common Mendelian disease, genetic counseling and genetic testing for FH should be implemented in daily clinical practice.
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Affiliation(s)
- Hayato Tada
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan;
| | - Masa-aki Kawashiri
- Department of Internal Medicine, Kaga Medical Center, Kaga 922-8522, Japan;
| | - Atsushi Nohara
- Department of Clinical Genetics, Ishikawa Prefectural Central Hospital, Kanazawa 920-8530, Japan;
| | - Tomoko Sekiya
- Division of Clinical Genetics, Kanazawa University Hospital, Kanazawa 920-8641, Japan; (T.S.); (A.W.)
| | - Atsushi Watanabe
- Division of Clinical Genetics, Kanazawa University Hospital, Kanazawa 920-8641, Japan; (T.S.); (A.W.)
| | - Masayuki Takamura
- Division of Cardiovascular Medicine, Kanazawa University Graduate School of Medicine, Kanazawa 920-8640, Japan;
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