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Chen J, Zhang H, Li L, Zhang X, Zhao D, Wang L, Wang J, Yang P, Sun H, Liu K, Chen W, Li L, Lin F, Li Z, Chen YE, Zhang J, Pang D, Ouyang H, He Y, Fan J, Tang X. Lp-PLA 2 (Lipoprotein-Associated Phospholipase A 2) Deficiency Lowers Cholesterol Levels and Protects Against Atherosclerosis in Rabbits. Arterioscler Thromb Vasc Biol 2023; 43:e11-e28. [PMID: 36412196 DOI: 10.1161/atvbaha.122.317898] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Elevated plasma Lp-PLA2 (lipoprotein-associated phospholipase A2) activity is closely associated with an increased risk of cardiovascular events. However, whether and how Lp-PLA2 is directly involved in the pathogenesis of atherosclerosis is still unclear. To examine the hypothesis that Lp-PLA2 could be a potential preventative target of atherosclerosis, we generated Lp-PLA2 knockout rabbits and investigated the pathophysiological functions of Lp-PLA2. METHODS Lp-PLA2 knockout rabbits were generated using CRISPR/Cas9 system to assess the role of Lp-PLA2 in plasma lipids regulation and identify its underlying molecular mechanisms. Homozygous knockout rabbits along with wild-type rabbits were fed a cholesterol-rich diet for up to 14 weeks and their atherosclerotic lesions were compared. Moreover, the effects of Lp-PLA2 deficiency on the key cellular behaviors in atherosclerosis were assessed in vitro. RESULTS When rabbits were fed a standard diet, Lp-PLA2 deficiency led to a significant reduction in plasma lipids. The decreased protein levels of SREBP2 (sterol regulatory element-binding protein 2) and HMGCR (3-hydroxy-3-methylglutaryl coenzyme A reductase) in livers of homozygous knockout rabbits indicated that the cholesterol biosynthetic pathway was impaired with Lp-PLA2 deficiency. In vitro experiments further demonstrated that intracellular Lp-PLA2 efficiently enhanced SREBP2-related cholesterol biosynthesis signaling independently of INSIGs (insulin-induced genes). When fed a cholesterol-rich diet, homozygous knockout rabbits exhibited consistently lower level of hypercholesterolemia, and their aortic atherosclerosis lesions were significantly reduced by 60.2% compared with those of wild-type rabbits. The lesions of homozygous knockout rabbits were characterized by reduced macrophages and the expression of inflammatory cytokines. Macrophages of homozygous knockout rabbits were insensitive to M1 polarization and showed reduced DiI-labeled lipoprotein uptake capacity compared with wild-type macrophages. Lp-PLA2 deficiency also inhibited the adhesion between monocytes and endothelial cells. CONCLUSIONS These results demonstrate that Lp-PLA2 plays a causal role in regulating blood lipid homeostasis and Lp-PLA2 deficiency protects against dietary cholesterol-induced atherosclerosis in rabbits. Lp-PLA2 could be a potential target for the prevention of atherosclerosis.
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Affiliation(s)
- Jiahuan Chen
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Huanyu Zhang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Linquan Li
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Xinwei Zhang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Dazhong Zhao
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Lingyu Wang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Jiaqi Wang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Ping Yang
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (P.Y., H.S., K.L., W.C., Y.H.)
| | - Huan Sun
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (P.Y., H.S., K.L., W.C., Y.H.)
| | - Kun Liu
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (P.Y., H.S., K.L., W.C., Y.H.)
| | - Weiwei Chen
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (P.Y., H.S., K.L., W.C., Y.H.)
| | - Lin Li
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Feng Lin
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Zhanjun Li
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.)
| | - Y Eugene Chen
- Department of Internal Medicine, Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor (Y.E.C., J.Z.)
| | - Jifeng Zhang
- Department of Internal Medicine, Center for Advanced Models for Translational Sciences and Therapeutics, University of Michigan Medical Center, Ann Arbor (Y.E.C., J.Z.)
| | - Daxin Pang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.).,Chongqing Research Institute, Jilin University, Chongqing, China (D.P., H.O., X.T.)
| | - Hongsheng Ouyang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.).,Chongqing Research Institute, Jilin University, Chongqing, China (D.P., H.O., X.T.)
| | - Yuquan He
- Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, China (P.Y., H.S., K.L., W.C., Y.H.)
| | - Jianglin Fan
- Department of Molecular Pathology, Faculty of Medicine, Graduate School of Medical Sciences, University of Yamanashi, Japan (J.F.)
| | - Xiaochun Tang
- College of Animal Sciences, Jilin University, Changchun, Jilin Province, China (J.C., H.Z., Linquan Li, X.Z., D.Z., L.W., J.W., Lin Li, F.L., Z.L., D.P., H.O., X.T.).,Chongqing Research Institute, Jilin University, Chongqing, China (D.P., H.O., X.T.)
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Association Lp-PLA2 Gene Polymorphisms with Coronary Heart Disease. DISEASE MARKERS 2022; 2022:9775699. [PMID: 35818585 PMCID: PMC9271005 DOI: 10.1155/2022/9775699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Accepted: 05/10/2022] [Indexed: 11/28/2022]
Abstract
Objectives The study evaluated the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) gene polymorphisms and coronary heart disease (CHD), in order to explore the molecular genetics of CHD. Methods Groups of CHD patients (n = 283) and healthy controls (n = 261) were involved in this study. R92H, V279F, and A379V polymorphisms of LP-PLA2 gene were confirmed using polymerase chain reaction (PCR) and direct DNA sequencing. These polymorphisms and their interaction were also analyzed as potential risk factors of CHD. Results In this study population, the genotypes of R92H (GG, GA, and AA), V279F (CC, AC, and AA) and A379V (GG, GA, and AA) were studied. There was a significantly difference in frequencies of R92H between CHD patients and controls (P < 0.05). In contrast, no significant difference in frequencies of V279F and A379V existed between CHD patients and controls. Furthermore, R92H and A379V were in strong linkage disequilibrium. Conclusions These results suggested that R92H polymorphism might contribute to increased risk of CHD.
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Interface of Phospholipase Activity, Immune Cell Function, and Atherosclerosis. Biomolecules 2020; 10:biom10101449. [PMID: 33076403 PMCID: PMC7602611 DOI: 10.3390/biom10101449] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 12/16/2022] Open
Abstract
Phospholipases are a family of lipid-altering enzymes that can either reduce or increase bioactive lipid levels. Bioactive lipids elicit signaling responses, activate transcription factors, promote G-coupled-protein activity, and modulate membrane fluidity, which mediates cellular function. Phospholipases and the bioactive lipids they produce are important regulators of immune cell activity, dictating both pro-inflammatory and pro-resolving activity. During atherosclerosis, pro-inflammatory and pro-resolving activities govern atherosclerosis progression and regression, respectively. This review will look at the interface of phospholipase activity, immune cell function, and atherosclerosis.
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Santoso A, Heriansyah T, Rohman MS. Phospholipase A2 is an Inflammatory Predictor in Cardiovascular Diseases: Is there any Spacious Room to Prove the Causation? Curr Cardiol Rev 2020; 16:3-10. [PMID: 31146670 PMCID: PMC7393598 DOI: 10.2174/1573403x15666190531111932] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 05/01/2019] [Accepted: 05/05/2019] [Indexed: 12/17/2022] Open
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme family of phospholipase A2 produced by the inflammatory cell in atherosclerotic plaque. It is transported in the circulation, attached mainly to low-density lipoprotein-cholesterol (LDL-C). It hydrolyzes glycerophospholipids particularly fatty acids at the sn-2 position and produces numerous bioactive lipids; and leads to endothelial dysfunction, atherosclerotic plaque inflammation, and development of the necrotic core in plaques. There are two kinds of phospholipase A2, namely: secretory phospholipase A2 (sPLA2) and Lp- PLA2. They are deemed as evolving predictors of cardiovascular disease (CVD) risk in hospitaland population-based studies, including healthy subjects, acute coronary syndromes (ACS) and patients with CVD. Unfortunately, Lp-PLA2 inhibitor (darapladib) and s-PLA2 inhibitor (varespladib methyl) failed to prove to lower the risk of composite CVD mortality, myocardial infarction and stroke in those with stable CVD and ACS. Herein, we describe the explanation based on the existing data why there is still a discrepancy among them. So, it highlights the opinion that phospholipase A2 is merely the inflammatory biomarkers of CVD and playing an important role in atherosclerosis. Further, there is more spacious room to prove the causation.
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Affiliation(s)
- Anwar Santoso
- Address correspondence to this author at the Department of Cardiology and Vascular Medicine, National Cardiovascular Centre, Harapan Kita Hospital, Universitas Indonesia, Jakarta, Indonesia; Tel: +62 21 5684093;
E-mail:
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Kono N, Arai H. Platelet-activating factor acetylhydrolases: An overview and update. Biochim Biophys Acta Mol Cell Biol Lipids 2018; 1864:922-931. [PMID: 30055287 DOI: 10.1016/j.bbalip.2018.07.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 01/22/2023]
Abstract
Platelet-activating factor acetylhydrolases (PAF-AHs) are unique members of the phospholipase A2 family that can hydrolyze the acetyl group of PAF, a signaling phospholipid that has roles in diverse (patho)physiological processes. Three types of PAF-AH have been identified in mammals, one plasma type and two intracellular types [PAF-AH (I) and PAF-AH (II)]. Plasma PAF-AH and PAF-AH (II) are monomeric enzymes that are structurally similar, while PAF-AH (I) is a multimeric enzyme with no homology to other PAF-AHs. PAF-AH (I) shows a strong preference for an acetyl group, whereas plasma PAF-AH and PAF-AH (II) also hydrolyze phospholipids with oxidatively modified fatty acids. Plasma PAF-AH has been implicated in several diseases including cardiovascular disease. PAF-AH (I) is required for spermatogenesis and is increasingly recognized as an oncogenic factor. PAF-AH (II) was recently shown to act as a bioactive lipid-producing enzyme in mast cells and thus could be a drug target for allergic diseases. This article is part of a Special Issue entitled Novel functions of phospholipase A2 Guest Editors: Makoto Murakami and Gerard Lambeau.
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Affiliation(s)
- Nozomu Kono
- Department of Health Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan; PRIME, Japan Agency for Medical Research and Development, 1-7-1 Otemachi, Chiyodaku, Tokyo 100-0004, Japan.
| | - Hiroyuki Arai
- Department of Health Chemistry, Graduate School of Pharmaceutical Sciences, The University of Tokyo, Bunkyo-ku, Tokyo 113-0033, Japan; AMED-CREST, Japan Agency for Medical Research and Development, 1-7-1 Otemachi, Chiyodaku, Tokyo 100-0004, Japan
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Schliefsteiner C, Hirschmugl B, Kopp S, Curcic S, Bernhart EM, Marsche G, Lang U, Desoye G, Wadsack C. Maternal Gestational Diabetes Mellitus increases placental and foetal lipoprotein-associated Phospholipase A2 which might exert protective functions against oxidative stress. Sci Rep 2017; 7:12628. [PMID: 28974763 PMCID: PMC5626711 DOI: 10.1038/s41598-017-13051-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2017] [Accepted: 09/18/2017] [Indexed: 12/13/2022] Open
Abstract
Increased Lipoprotein associated phospholipase A2 (LpPLA2) has been associated with inflammatory pathologies, including Type 2 Diabetes. Studies on LpPLA2 and Gestational Diabetes Mellitus (GDM) are rare, and have focused mostly on maternal outcome. In the present study, we investigated whether LpPLA2 activity on foetal lipoproteins is altered by maternal GDM and/or obesity (a major risk factor for GDM), thereby contributing to changes in lipoprotein functionality. We identified HDL as the major carrier of LpPLA2 activity in the foetus, which is in contrast to adults. We observed marked expression of LpPLA2 in placental macrophages (Hofbauer cells; HBCs) and found that LpPLA2 activity in these cells was increased by insulin, leptin, and pro-inflammatory cytokines. These regulators were also increased in plasma of children born from GDM pregnancies. Our results suggest that insulin, leptin, and pro-inflammatory cytokines are positive regulators of LpPLA2 activity in the foeto-placental unit. Of particular interest, functional assays using a specific LpPLA2 inhibitor suggest that high-density lipoprotein (HDL)-associated LpPLA2 exerts anti-oxidative, athero-protective functions on placental endothelium and foetus. Our results therefore raise the possibility that foetal HDL-associated LpPLA2 might act as an anti-inflammatory enzyme improving vascular barrier function.
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Affiliation(s)
| | - Birgit Hirschmugl
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
- BioTechMed-Graz, Graz, Austria
| | - Susanne Kopp
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Sanja Curcic
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Eva Maria Bernhart
- Institute of Molecular Biology and Biochemistry, Medical University of Graz, Graz, Austria
| | - Gunther Marsche
- Department of Clinical and Experimental Pharmacology, Medical University of Graz, Graz, Austria
| | - Uwe Lang
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Gernot Desoye
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria
| | - Christian Wadsack
- Department of Obstetrics and Gynaecology, Medical University of Graz, Graz, Austria.
- BioTechMed-Graz, Graz, Austria.
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7
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Yeo A, Li L, Warren L, Aponte J, Fraser D, King K, Johansson K, Barnes A, MacPhee C, Davies R, Chissoe S, Tarka E, O’Donoghue ML, White HD, Wallentin L, Waterworth D. Pharmacogenetic meta-analysis of baseline risk factors, pharmacodynamic, efficacy and tolerability endpoints from two large global cardiovascular outcomes trials for darapladib. PLoS One 2017; 12:e0182115. [PMID: 28753643 PMCID: PMC5533343 DOI: 10.1371/journal.pone.0182115] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2016] [Accepted: 07/11/2017] [Indexed: 01/27/2023] Open
Abstract
Darapladib, a lipoprotein-associated phospholipase A2 (Lp-PLA2) inhibitor, failed to demonstrate efficacy for the primary endpoints in two large phase III cardiovascular outcomes trials, one in stable coronary heart disease patients (STABILITY) and one in acute coronary syndrome (SOLID-TIMI 52). No major safety signals were observed but tolerability issues of diarrhea and odor were common (up to 13%). We hypothesized that genetic variants associated with Lp-PLA2 activity may influence efficacy and tolerability and therefore performed a comprehensive pharmacogenetic analysis of both trials. We genotyped patients within the STABILITY and SOLID-TIMI 52 trials who provided a DNA sample and consent (n = 13,577 and 10,404 respectively, representing 86% and 82% of the trial participants) using genome-wide arrays with exome content and performed imputation using a 1000 Genomes reference panel. We investigated baseline and change from baseline in Lp-PLA2 activity, two efficacy endpoints (major coronary events and myocardial infarction) as well as tolerability parameters at genome-wide and candidate gene level using a meta-analytic approach. We replicated associations of published loci on baseline Lp-PLA2 activity (APOE, CELSR2, LPA, PLA2G7, LDLR and SCARB1) and identified three novel loci (TOMM5, FRMD5 and LPL) using the GWAS-significance threshold P≤5E-08. Review of the PLA2G7 gene (encoding Lp-PLA2) within these datasets identified V279F null allele carriers as well as three other rare exonic null alleles within various ethnic groups, however none of these variants nor any other loci associated with Lp-PLA2 activity at baseline were associated with any of the drug response endpoints. The analysis of darapladib efficacy endpoints, despite low power, identified six low frequency loci with main genotype effect (though with borderline imputation scores) and one common locus (minor allele frequency 0.24) with genotype by treatment interaction effect passing the GWAS-significance threshold. This locus conferred risk in placebo subjects, hazard ratio (HR) 1.22 with 95% confidence interval (CI) 1.11–1.33, but was protective in darapladib subjects, HR 0.79 (95% CI 0.71–0.88). No major loci for tolerability were found. Thus, genetic analysis confirmed and extended the influence of lipoprotein loci on Lp-PLA2 levels, identified some novel null alleles in the PLA2G7 gene, and only identified one potentially efficacious subgroup within these two large clinical trials.
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Affiliation(s)
- Astrid Yeo
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Stevenage, Hertfordshire, United Kingdom
| | - Li Li
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Liling Warren
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Jennifer Aponte
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Dana Fraser
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Karen King
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Kelley Johansson
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Allison Barnes
- Clinical Statistics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Colin MacPhee
- Department of Vascular Biology & Thrombosis, GlaxoSmithKline Medicines Research Centre, King of Prussia, Pennsylvania, United States of America
| | - Richard Davies
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline Medicines Research Centre, King of Prussia, Pennsylvania, United States of America
| | - Stephanie Chissoe
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Research Triangle Park, North Carolina, United States of America
| | - Elizabeth Tarka
- Metabolic Pathways and Cardiovascular Therapeutic Area, GlaxoSmithKline Medicines Research Centre, King of Prussia, Pennsylvania, United States of America
| | - Michelle L. O’Donoghue
- TIMI Study Group, Cardiovascular Division, Brigham and Women’s Hospital, Boston, Massachusetts, United States of America
| | - Harvey D. White
- Green Lane Cardiovascular Service, Auckland City Hospital and University of Auckland, Auckland, New Zealand
| | - Lars Wallentin
- Department of Medical Sciences, Cardiology & Uppsala Clinical Research Center, Uppsala University, Uppsala, Sweden
| | - Dawn Waterworth
- Department of Genetics, GlaxoSmithKline Medicines Research Centre, Upper Merion, Philadelphia, Pennsylvania, United States of America
- * E-mail:
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8
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Gregson JM, Freitag DF, Surendran P, Stitziel NO, Chowdhury R, Burgess S, Kaptoge S, Gao P, Staley JR, Willeit P, Nielsen SF, Caslake M, Trompet S, Polfus LM, Kuulasmaa K, Kontto J, Perola M, Blankenberg S, Veronesi G, Gianfagna F, Männistö S, Kimura A, Lin H, Reilly DF, Gorski M, Mijatovic V, Munroe PB, Ehret GB, Thompson A, Uria-Nickelsen M, Malarstig A, Dehghan A, Vogt TF, Sasaoka T, Takeuchi F, Kato N, Yamada Y, Kee F, Müller-Nurasyid M, Ferrières J, Arveiler D, Amouyel P, Salomaa V, Boerwinkle E, Thompson SG, Ford I, Wouter Jukema J, Sattar N, Packard CJ, Shafi Majumder AA, Alam DS, Deloukas P, Schunkert H, Samani NJ, Kathiresan S, Nordestgaard BG, Saleheen D, Howson JMM, Di Angelantonio E, Butterworth AS, Danesh J. Genetic invalidation of Lp-PLA 2 as a therapeutic target: Large-scale study of five functional Lp-PLA 2-lowering alleles. Eur J Prev Cardiol 2017; 24:492-504. [PMID: 27940953 PMCID: PMC5460752 DOI: 10.1177/2047487316682186] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2016] [Accepted: 10/24/2016] [Indexed: 01/12/2023]
Abstract
Aims Darapladib, a potent inhibitor of lipoprotein-associated phospholipase A2 (Lp-PLA2), has not reduced risk of cardiovascular disease outcomes in recent randomized trials. We aimed to test whether Lp-PLA2 enzyme activity is causally relevant to coronary heart disease. Methods In 72,657 patients with coronary heart disease and 110,218 controls in 23 epidemiological studies, we genotyped five functional variants: four rare loss-of-function mutations (c.109+2T > C (rs142974898), Arg82His (rs144983904), Val279Phe (rs76863441), Gln287Ter (rs140020965)) and one common modest-impact variant (Val379Ala (rs1051931)) in PLA2G7, the gene encoding Lp-PLA2. We supplemented de-novo genotyping with information on a further 45,823 coronary heart disease patients and 88,680 controls in publicly available databases and other previous studies. We conducted a systematic review of randomized trials to compare effects of darapladib treatment on soluble Lp-PLA2 activity, conventional cardiovascular risk factors, and coronary heart disease risk with corresponding effects of Lp-PLA2-lowering alleles. Results Lp-PLA2 activity was decreased by 64% ( p = 2.4 × 10-25) with carriage of any of the four loss-of-function variants, by 45% ( p < 10-300) for every allele inherited at Val279Phe, and by 2.7% ( p = 1.9 × 10-12) for every allele inherited at Val379Ala. Darapladib 160 mg once-daily reduced Lp-PLA2 activity by 65% ( p < 10-300). Causal risk ratios for coronary heart disease per 65% lower Lp-PLA2 activity were: 0.95 (0.88-1.03) with Val279Phe; 0.92 (0.74-1.16) with carriage of any loss-of-function variant; 1.01 (0.68-1.51) with Val379Ala; and 0.95 (0.89-1.02) with darapladib treatment. Conclusions In a large-scale human genetic study, none of a series of Lp-PLA2-lowering alleles was related to coronary heart disease risk, suggesting that Lp-PLA2 is unlikely to be a causal risk factor.
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Affiliation(s)
- John M Gregson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Daniel F Freitag
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Praveen Surendran
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Nathan O Stitziel
- Departments of Medicine and Genetics, Washington University School of Medicine, St Louis, USA
| | - Rajiv Chowdhury
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Stephen Burgess
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Stephen Kaptoge
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Pei Gao
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - James R Staley
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Peter Willeit
- Department of Public Health and Primary Care, University of Cambridge, UK
- Department of Neurology, Innsbruck Medical University, Austria
| | - Sune F Nielsen
- Copenhagen University Hospital, University of Copenhagen, Denmark
| | | | | | | | - Kari Kuulasmaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Jukka Kontto
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Markus Perola
- Institute of Molecular Medicine FIMM, University of Helsinki, Finland
- Department of Health, National Institute for Health and Welfare, Helsinki, Finland
| | - Stefan Blankenberg
- Department of General and Interventional Cardiology, University Heart Centre Hamburg, Germany
- University Medical Centre Hamburg Eppendorf, Hamburg, Germany
| | - Giovanni Veronesi
- Research Centre, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
| | - Francesco Gianfagna
- Research Centre, Department of Clinical and Experimental Medicine, University of Insubria, Varese, Italy
- Department of Epidemiology and Prevention, IRCCS Istituto Neurologico Mediterraneo Neuromed, Pozzilli, Italy
| | - Satu Männistö
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Akinori Kimura
- Department of Molecular Pathogenesis, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Japan
| | - Honghuang Lin
- Section of Computational Biomedicine, Department of Medicine, Boston University School of Medicine, USA
- The NHLBI’s Framingham Heart Study, Framingham, USA
| | - Dermot F Reilly
- Merck Research Laboratories, Genetics and Pharmacogenomics, Boston, USA
| | - Mathias Gorski
- Department of Genetic Epidemiology, University of Regensburg, Germany
- Department of Nephrology, University Hospital Regensburg, Germany
| | - Vladan Mijatovic
- Department of Life and Reproduction Sciences, University of Verona, Italy
| | | | - Patricia B Munroe
- Clinical Pharmacology and The Genome Centre, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
- NIHR Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, UK
| | - Georg B Ehret
- Center for Complex Disease Genomics, McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, USA
- Cardiology, Department of Medicine, Geneva University Hospital, Switzerland
- Institute of Social and Preventive Medicine (IUMSP), Centre Hospitalier Universitaire Vaudois and University of Lausanne, Lausanne, Switzerland
| | | | | | | | | | - Abbas Dehghan
- Department of Epidemiology, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | | | - Thomas F Vogt
- Merck Research Laboratories, Cardiometabolic Disease, Kenilworth, USA
- CHDI Management/CHDI Foundation, Princeton, USA
| | - Taishi Sasaoka
- Department of Molecular Pathogenesis, Medical Research Institute, Tokyo Medical and Dental University (TMDU), Japan
| | - Fumihiko Takeuchi
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Norihiro Kato
- Department of Gene Diagnostics and Therapeutics, Research Institute, National Centre for Global Health and Medicine, Tokyo, Japan
| | - Yoshiji Yamada
- Department of Human Functional Genomics, Life Science Research Centre, Mie University, Japan
| | - Frank Kee
- UKCRC Centre of Excellence for Public Health, Queens University, Belfast, Ireland
| | - Martina Müller-Nurasyid
- Institute of Genetic Epidemiology, Helmholtz Zentrum München - German Research Centre for Environmental Health, Neuherberg, Germany
- Institute of Medical Informatics, Biometry and Epidemiology, Ludwig-Maximilians-Universität, Munich, Germany
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Department of Medicine I, Ludwig-Maximilians-University Munich, Germany
| | - Jean Ferrières
- Department of Epidemiology, UMR 1027-INSERM, Toulouse University-CHU Toulouse, France
| | - Dominique Arveiler
- Department of Epidemiology and Public Health, EA 3430, University of Strasbourg and Strasbourg University Hospital, France
| | - Philippe Amouyel
- Department of Epidemiology and Public Health, Institut Pasteur de Lille, France
| | - Veikko Salomaa
- THL-National Institute for Health and Welfare, Helsinki, Finland
| | - Eric Boerwinkle
- Human Genetics Center, University of Texas Health Science Center at Houston, USA
| | - Simon G Thompson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | | | | | | | | | | | - Dewan S Alam
- Centre for Global Health Research, St Michael Hospital, Toronto, Canada
| | - Panos Deloukas
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, UK
| | - Heribert Schunkert
- DZHK (German Centre for Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany
- Deutsches Herzzentrum München, Technische Universität München, Germany
| | - Nilesh J Samani
- Department of Cardiovascular Sciences, University of Leicester and National Institute for Health Research Leicester Cardiovascular Biomedical Research Unit, UK
| | - Sekar Kathiresan
- Broad Institute, Cambridge and Massachusetts General Hospital, Boston, USA
| | | | | | | | - Joanna MM Howson
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Emanuele Di Angelantonio
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - Adam S Butterworth
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
| | - John Danesh
- MRC/BHF Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, UK
- Wellcome Trust Sanger Institute, Hinxton, Cambridge, UK
- British Heart Foundation Cambridge Centre of Excellence, University of Cambridge, Cambridge, UK
- National Institute of Health Research Blood and Transplant Research Unit in Donor Health and Genomics, University of Cambridge, Cambridge, UK
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9
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Measom ND, Down KD, Hirst DJ, Jamieson C, Manas ES, Patel VK, Somers DO. Investigation of a Bicyclo[1.1.1]pentane as a Phenyl Replacement within an LpPLA 2 Inhibitor. ACS Med Chem Lett 2017; 8:43-48. [PMID: 28105273 DOI: 10.1021/acsmedchemlett.6b00281] [Citation(s) in RCA: 137] [Impact Index Per Article: 19.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 11/15/2016] [Indexed: 02/07/2023] Open
Abstract
We describe the incorporation of a bicyclo[1.1.1]pentane moiety within two known LpPLA2 inhibitors to act as bioisosteric phenyl replacements. An efficient synthesis to the target compounds was enabled with a dichlorocarbene insertion into a bicyclo[1.1.0]butane system being the key transformation. Potency, physicochemical, and X-ray crystallographic data were obtained to compare the known inhibitors to their bioisosteric counterparts, which showed the isostere was well tolerated and positively impacted on the physicochemical profile.
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Affiliation(s)
- Nicholas D. Measom
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
- Department
of Pure and Applied Chemistry, University of Strathclyde, Thomas
Graham Building, 295 Cathedral Street, Glasgow, G1 1XL, U.K
| | - Kenneth D. Down
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - David J. Hirst
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Craig Jamieson
- Department
of Pure and Applied Chemistry, University of Strathclyde, Thomas
Graham Building, 295 Cathedral Street, Glasgow, G1 1XL, U.K
| | - Eric S. Manas
- GlaxoSmithKline, 1250 South Collegeville Road, Collegeville, Pennsylvania 19426-0989, United States
| | - Vipulkumar K. Patel
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
| | - Don O. Somers
- GlaxoSmithKline, Medicines Research Centre, Gunnels Wood Road, Stevenage, Hertfordshire, SG1 2NY, U.K
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10
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Ballantyne C, Cushman M, Psaty B, Furberg C, Khaw KT, Sandhu M, Oldgren J, Rossi GP, Maiolino G, Cesari M, Lenzini L, James SK, Rimm E, Collins R, Anderson J, Koenig W, Brenner H, Rothenbacher D, Berglund G, Persson M, Berger P, Brilakis E, McConnell JP, Koenig W, Sacco R, Elkind M, Talmud P, Rimm E, Cannon CP, Packard C, Barrett-Connor E, Hofman A, Kardys I, Witteman JCM, Criqui M, Corsetti JP, Rainwater DL, Moss AJ, Robins S, Bloomfield H, Collins D, Packard C, Wassertheil-Smoller S, Ridker P, Ballantyne C, Cannon CP, Cushman M, Danesh J, Gu D, Hofman A, Nelson JJ, Thompson S, Zalewski A, Zariffa N, Di Angelantonio E, Kaptoge S, Thompson A, Thompson S, Walker M, Watson S, Wood A. Collaborative meta-analysis of individual participant data from observational studies of Lp-PLA2 and cardiovascular diseases. ACTA ACUST UNITED AC 2016; 14:3-11. [PMID: 17301621 DOI: 10.1097/01.hjr.0000239464.18509.f1] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND A large number of observational epidemiological studies have reported generally positive associations between circulating mass and activity levels of lipoprotein-associated phospholipase A2 (Lp-PLA2) and the risk of cardiovascular diseases. Few studies have been large enough to provide reliable estimates in different circumstances, such as in different subgroups (e.g., by age group, sex, or smoking status) or at different Lp-PLA2 levels. Moreover, most published studies have related disease risk only to baseline values of Lp-PLA2 markers (which can lead to substantial underestimation of any risk relationships because of within-person variability over time) and have used different approaches to adjustment for possible confounding factors. OBJECTIVES By combination of data from individual participants from all relevant observational studies in a systematic 'meta-analysis', with correction for regression dilution (using available data on serial measurements of Lp-PLA2), the Lp-PLA2 Studies Collaboration will aim to characterize more precisely than has previously been possible the strength and shape of the age and sex-specific associations of plasma Lp-PLA2 with coronary heart disease (and, where data are sufficient, with other vascular diseases, such as ischaemic stroke). It will also help to determine to what extent such associations are independent of possible confounding factors and to explore potential sources of heterogeneity among studies, such as those related to assay methods and study design. It is anticipated that the present collaboration will serve as a framework to investigate related questions on Lp-PLA2 and cardiovascular outcomes. METHODS A central database is being established containing data on circulating Lp-PLA2 values, sex and other potential confounding factors, age at baseline Lp-PLA2 measurement, age at event or at last follow-up, major vascular morbidity and cause-specific mortality. Information about any repeat measurements of Lp-PLA2 and potential confounding factors has been sought to allow adjustment for possible confounding and correction for regression dilution. The analyses will involve age-specific regression models. Synthesis of the available observational studies of Lp-PLA2 will yield information on a total of about 15 000 cardiovascular disease endpoints.
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11
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Millwood IY, Bennett DA, Walters RG, Clarke R, Waterworth D, Johnson T, Chen Y, Yang L, Guo Y, Bian Z, Hacker A, Yeo A, Parish S, Hill MR, Chissoe S, Peto R, Cardon L, Collins R, Li L, Chen Z. A phenome-wide association study of a lipoprotein-associated phospholipase A2 loss-of-function variant in 90 000 Chinese adults. Int J Epidemiol 2016; 45:1588-1599. [PMID: 27301456 PMCID: PMC5100610 DOI: 10.1093/ije/dyw087] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/24/2016] [Indexed: 12/20/2022] Open
Abstract
Background: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been implicated in development of atherosclerosis; however, recent randomized trials of Lp-PLA2 inhibition reported no beneficial effects on vascular diseases. In East Asians, a loss-of-function variant in the PLA2G7 gene can be used to assess the effects of genetically determined lower Lp-PLA2. Methods:PLA2G7 V279F (rs76863441) was genotyped in 91 428 individuals randomly selected from the China Kadoorie Biobank of 0.5 M participants recruited in 2004–08 from 10 regions of China, with 7 years’ follow-up. Linear regression was used to assess effects of V279F on baseline traits. Logistic regression was conducted for a range of vascular and non-vascular diseases, including 41 ICD-10 coded disease categories. Results:PLA2G7 V279F frequency was 5% overall (range 3–7% by region), and 9691 (11%) participants had at least one loss-of-function variant. V279F was not associated with baseline blood pressure, adiposity, blood glucose or lung function. V279F was not associated with major vascular events [7141 events; odds ratio (OR) = 0.98 per F variant, 95% confidence interval (CI) 0.90-1.06] or other vascular outcomes, including major coronary events (922 events; 0.96, 0.79-1.18) and stroke (5967 events; 1.00, 0.92-1.09). Individuals with V279F had lower risks of diabetes (7031 events; 0.91, 0.84-0.98) and asthma (182 events; 0.53, 0.28-0.98), but there was no association after adjustment for multiple testing. Conclusions: Lifelong lower Lp-PLA2 activity was not associated with major risks of vascular or non-vascular diseases in Chinese adults. Using functional genetic variants in large-scale prospective studies with linkage to a range of health outcomes is a valuable approach to inform drug development and repositioning.
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Affiliation(s)
- Iona Y Millwood
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Derrick A Bennett
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Robin G Walters
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Robert Clarke
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Dawn Waterworth
- GlaxoSmithKline (GSK) Medicines Research Centre, GSK, Stevenage, UK, Research Triangle Park, NC, USA and King of Prussia, PA, USA
| | - Toby Johnson
- GlaxoSmithKline (GSK) Medicines Research Centre, GSK, Stevenage, UK, Research Triangle Park, NC, USA and King of Prussia, PA, USA
| | - Yiping Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Ling Yang
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China and
| | - Zheng Bian
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China and
| | - Alex Hacker
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Astrid Yeo
- GlaxoSmithKline (GSK) Medicines Research Centre, GSK, Stevenage, UK, Research Triangle Park, NC, USA and King of Prussia, PA, USA
| | - Sarah Parish
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Michael R Hill
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Stephanie Chissoe
- GlaxoSmithKline (GSK) Medicines Research Centre, GSK, Stevenage, UK, Research Triangle Park, NC, USA and King of Prussia, PA, USA
| | - Richard Peto
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Lon Cardon
- GlaxoSmithKline (GSK) Medicines Research Centre, GSK, Stevenage, UK, Research Triangle Park, NC, USA and King of Prussia, PA, USA
| | - Rory Collins
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
| | - Liming Li
- Chinese Academy of Medical Sciences, Dong Cheng District, Beijing, China and.,Department of Epidemiology & Biostatistics, Peking University Health Science Centre, Beijing, China
| | - Zhengming Chen
- Clinical Trial Service Unit & Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, UK
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12
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Ueshima H, Kadowaki T, Hisamatsu T, Fujiyoshi A, Miura K, Ohkubo T, Sekikawa A, Kadota A, Kadowaki S, Nakamura Y, Miyagawa N, Okamura T, Kita Y, Takashima N, Kashiwagi A, Maegawa H, Horie M, Yamamoto T, Kimura T, Kita T. Lipoprotein-associated phospholipase A2 is related to risk of subclinical atherosclerosis but is not supported by Mendelian randomization analysis in a general Japanese population. Atherosclerosis 2016; 246:141-7. [DOI: 10.1016/j.atherosclerosis.2015.12.027] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 12/07/2015] [Accepted: 12/19/2015] [Indexed: 02/02/2023]
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13
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[Lp-PLA2, a biomarker of vascular inflammation and vulnerability of atherosclerosis plaques]. ANNALES PHARMACEUTIQUES FRANÇAISES 2015; 74:190-7. [PMID: 26499399 DOI: 10.1016/j.pharma.2015.09.002] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Accepted: 09/09/2015] [Indexed: 01/21/2023]
Abstract
A chronic inflammation is involved in various stages of development of the atherosclerotic plaques. Among the emerging biomarkers of atherogenesis, the lipoprotein-associated phospholipase A2 (Lp-PLA2), formerly known as PAF-acetylhydrolase (McIntyre et al., 2009), hydrolyses the oxidized short chain phospholipids of low-density lipoproteins (LDL), thereby releasing pro-inflammatory mediators (lysophospholipids and oxidized fatty acids). Lp-PLA2, produced by monocytes/macrophages and T-lymphocytes, and mainly associated with LDL (Gazi et al., 2005), is predominantly expressed in the necrotic center of the atherosclerotic plaques and in the macrophage-rich areas (Kolodgie et al., 2006). It would have a predictive role of cardiovascular (CV) events in relation to the vulnerability of atherosclerotic plaques. Determination of Lp-PLA2 has been proposed in the assessment of the CV risk, to ensure a better stratification of populations at intermediate risk for targeted therapy (Davidson et al., 2008). Its proatherogenic role suggested that inhibition of its activity could ensure a better vascular protection in combination with cholesterol-lowering agents. Nevertheless, Lp-PLA2 is not yet a fully validated marker for use in daily clinical practice, especially since the studies using an inhibitor of Lp-PLA2 (darapladib) (STABILITY Investigators et al., 2014; O'Donoghue et al., 2014) did not show any reduction in coronary events. Lp-PLA2 could have a site-specific role in plaque inflammation and development (Fenning et al., 2015). High Lp-PLA2 activity could reflect a response to pro-inflammatory stress characteristic of atherosclerosis (Marathe et al., 2014). This presentation aims at clarifying the involvement of Lp-PLA2 in the pathophysiology of atherosclerosis, and at assessing its interest both as a biomarker for the onset of CV events and as a therapeutic target.
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14
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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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15
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Garg PK, McClelland RL, Jenny NS, Criqui MH, Greenland P, Rosenson RS, Siscovick DS, Jorgensen N, Cushman M. Lipoprotein-associated phospholipase A2 and risk of incident cardiovascular disease in a multi-ethnic cohort: The multi ethnic study of atherosclerosis. Atherosclerosis 2015; 241:176-82. [PMID: 26004387 PMCID: PMC4504012 DOI: 10.1016/j.atherosclerosis.2015.05.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 04/10/2015] [Accepted: 05/13/2015] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Prospective studies reporting a positive association of lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity with incident cardiovascular disease (CVD) have included primarily white individuals. We evaluated associations of Lp-PLA2 and first-time cardiovascular events in a healthy multi-ethnic cohort characterized by presence or absence of baseline subclinical atherosclerosis. METHODS Lp-PLA2 mass and activity were measured at baseline in 5456 participants in the Multi-Ethnic Study of Atherosclerosis. Individuals were characterized for presence of baseline subclinical disease (coronary artery calcium score > 0 or carotid intima-media thickness value > 80th percentile) and followed prospectively for development of CVD events (coronary heart disease, ischemic stroke, and cardiovascular death). RESULTS 516 incident CVD events occurred over median follow-up of 10.2 years. In adjusted Cox proportional hazards models, each higher standard deviation of both Lp-PLA2 activity and mass was associated with an increased risk of cardiovascular events; hazard ratios (HR; 95% confidence intervals (CI)) 1.12 (1.01-1.26) for Lp-PLA2 activity and 1.10 (1.01-1.21) for mass. Associations did not differ by subclinical disease status (p-value for interaction 0.99 for Lp-PLA2 activity and 0.32 for Lp-PLA2 mass) and there was no confounding by subclinical atherosclerosis measures. Associations of Lp-PLA2 activity but not mass were weaker in Chinese participants but there were relatively few events among Chinese in race-stratified analysis. CONCLUSION In this multi-ethnic cohort, Lp-PLA2 was positively associated with CVD risk, regardless of the presence of coronary artery calcium or a thickened carotid-intimal media.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | | | - Nancy S Jenny
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Michael H Criqui
- Department of Family & Preventive Medicine, University of California in San Diego, La Jolla, CA, USA
| | - Philip Greenland
- Department of Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA; Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Neal Jorgensen
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Mary Cushman
- Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA; Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA.
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16
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Effects of A379V variant of the Lp-PLA 2 gene on Lp-PLA 2 activity and markers of oxidative stress and endothelial function in Koreans. J Thromb Thrombolysis 2015; 38:477-84. [PMID: 24682749 DOI: 10.1007/s11239-014-1074-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A379V variant in the lipoprotein-associated phospholipase A2 (Lp-PLA 2) gene is known to be functional, but there are contradicting data concerning the A379V polymorphism, Lp-PLA2 activity and cardiovascular disease risk. We determined the interplay between A379V SNP, Lp-PLA2 activity, and markers of oxidative stress and endothelial function with and without the effect of V279F variant. 3,220 unrelated and healthy Koreans (40-79 years) were genotyped for the Lp-PLA 2 polymorphism (A379V and V279F). Lp-PLA2 activity and markers of oxidative stress and endothelial function were measured. Lp-PLA2 activity was 3.9% higher in A/V subjects (n = 821) and 7.8% in V/V (n = 79) than in those with A/A (n = 2,320). Urinary levels of 8-epi-PGF2α were significantly lower in subjects with the A/V or the V/V genotype than in those with the A/A genotype (A/A; 1,426 ± 14, A/V; 1,371 ± 26, V/V; 1,199 ± 58 pg/mg creatinine, P = 0.003). Subjects with the 379 V/V genotype had lower serum concentrations of sICAM-1 and p-selectin compared to those with the A/A or the A/V genotype. When subjects were further stratified into subgroups based on the combination of A379V and V279F genotypes, there was no significant association between A379V genotypes and Lp-PLA2 activities in the 279 V/V group. However, the associations of the A379V SNP with levels of 8-epi-PGF2α, sICAM-1, and p-selectin remained in the subset analysis based on the V279F genotypes. This study showed a reduction in oxidative stress in subjects carrying 379V allele and the recessive effect of the A379V on the endothelial function. It is likely that the A379V polymorphism has a qualitative effect, probably by disrupting the affinity of Lp-PLA2 for platelet-activating factor substrate, towards a more anti-oxidative or anti-atherogenic form.
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Karasawa K. Naturally Occurring Missense Mutation in Plasma PAF-AH Among the Japanese Population. Enzymes 2015; 38:117-43. [PMID: 26612650 DOI: 10.1016/bs.enz.2015.09.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
A single nucleotide polymorphism in the plasma PAF-AH enzyme, i.e., G994T, which causes the substitution of Val at amino acid 279 with Phe (V279F), has been found in the Japanese population. This enzyme preferentially degrades oxidatively modulated or truncated phospholipids; therefore, it has been suggested that this enzyme may prevent the accumulation of proinflammatory and proatherogenic oxidized phospholipids. This hypothesis is supported by the higher prevalence of the V279F mutation in patients with asthmatic and atherosclerotic diseases, as compared with healthy controls. This mutation is rare in the Caucasian population. The plasma PAF-AH mass and enzyme activity are distributed over a wide range in the plasma and they are positively correlated with low-density lipoprotein (LDL) cholesterol. However, several clinical studies in the Caucasian population have suggested that this enzyme has the opposite role. This enzyme plays an active role in the development and progression of atherosclerosis via proinflammatory and proatherogenic lysophosphatidylcholine and oxidized fatty acids produced through the oxidation of LDL by this enzyme. Thus, plasma PAF-AH is a unique enzyme with dual roles in human inflammatory diseases. In this chapter, on the basis of recent findings we describe the association between a naturally occurring missense mutation in plasma PAF-AH and human diseases especially including atherosclerosis and asthma.
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Affiliation(s)
- Ken Karasawa
- Faculty of Pharmaceutical Sciences, Teikyo University, Tokyo, Japan.
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18
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Karasawa K, Inoue K. Overview of PAF-Degrading Enzymes. PLATELET-ACTIVATING FACTOR ACETYLHYDROLASES (PAF-AH) 2015; 38:1-22. [DOI: 10.1016/bs.enz.2015.09.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Karabina S, Ninio E. Plasma PAFAH/PLA2G7 Genetic Variability, Cardiovascular Disease, and Clinical Trials. ACTA ACUST UNITED AC 2015; 38:145-55. [DOI: 10.1016/bs.enz.2015.09.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zheng GH, Xiong SQ, Chen HY, Mei LJ, Wang T. Associations of platelet-activating factor acetylhydrolase (PAF-AH) gene polymorphisms with circulating PAF-AH levels and risk of coronary heart disease or blood stasis syndrome in the Chinese Han population. Mol Biol Rep 2014; 41:7141-51. [PMID: 25034894 DOI: 10.1007/s11033-014-3597-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2013] [Accepted: 07/07/2014] [Indexed: 02/07/2023]
Abstract
The circulating level of platelet-activating factor acetylhydrolase (PAF-AH) is a novel biomarker to predict the presence of coronary heart disease. PAF-AH gene polymorphisms may be responsible for the variance of circulating PAF-AH levels in individuals. However, the association of PAF-AH gene polymorphisms with circulating PAF-AH levels and the susceptibility to coronary heart disease (CHD) remains unsolved. Blood stasis syndrome (BSS) of CHD is the most common type of TCM syndromes, and a previous study discovered its relationship with the elevated circulating PAF-AH levels. However, the association of gene polymorphisms and CHD with BSS is unclear at present. In this study, four polymorphisms (R92H, I198T, A379V, V279F) of the PAF-AH gene were genotyped in 570 CHD patients, of which 299 had BSS. In addition, 317 unaffected individuals from the same hospitals served as controls. Plasma PAF-AH levels were measured in 155 controls and 271 CHD patients selected randomly, including 139 CHD patients with BSS. In the Chinese Han population, plasma PAF-AH levels in CHD patients with BSS or without BSS were significantly higher (12.9 ± 6.5 and 11.1 ± 5.0 μM, respectively) than in controls (9.3 ± 5.2 μM); this difference still remained significant after adjustment for traditional risk factors or the inflammatory factors. The R92H polymorphism was highly related to the plasma PAF-AH levels and the risk of CHD, especially among patients with BSS, even with the adjustment for the effects of traditional factors. The I198T polymorphism was highly associated with risk of CHD with BSS, but was associated with neither the risk of CHD with no BSS nor with elevated plasma PAF-AH levels.
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Affiliation(s)
- Guo-Hua Zheng
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou, 350108, Fujian, China,
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21
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Woudstra P, Damman P, Kuijt WJ, Kikkert WJ, Grundeken MJ, van Brussel PM, Stroobants AK, van Straalen JP, Fischer JC, Koch KT, Henriques JPS, Piek JJ, Tijssen JGP, de Winter RJ. Admission lipoprotein-associated phospholipase A2 activity is not associated with long-term clinical outcomes after ST-segment elevation myocardial infarction. PLoS One 2014; 9:e96251. [PMID: 24788873 PMCID: PMC4006846 DOI: 10.1371/journal.pone.0096251] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2013] [Accepted: 04/07/2014] [Indexed: 12/31/2022] Open
Abstract
Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) activity is a biomarker predicting cardiovascular diseases in a real-world. However, the prognostic value in patients undergoing primary percutaneous coronary intervention (pPCI) for ST-segment elevation myocardial infarction (STEMI) on long-term clinical outcomes is unknown. Methods Lp-PLA2 activity was measured in samples obtained prior to pPCI from consecutive STEMI patients in a high-volume intervention center from 2005 until 2007. Five years all-cause mortality was estimated with the Kaplan-Meier method and compared among tertiles of Lp-PLA2 activity during complete follow-up and with a landmark at 30 days. In a subpopulation clinical endpoints were assessed at three years. The prognostic value of Lp-PLA2, in addition to the Thrombolysis In Myocardial Infarction or multimarker risk score, was assessed in multivariable Cox regression. Results The cohort (n = 987) was divided into tertiles (low <144, intermediate 144–179, and high >179 nmol/min/mL). Among the tertiles differences in baseline characteristics associated with long-term mortality were observed. However, no significant differences in five years mortality in association with Lp-PLA2 activity levels were found; intermediate versus low Lp-PLA2 (HR 0.97; CI 95% 0.68–1.40; p = 0.88) or high versus low Lp-PLA2 (HR 0.75; CI 95% 0.51–1.11; p = 0.15). Both in a landmark analysis and after adjustments for the established risk scores and selection of cases with biomarkers obtained, non-significant differences among the tertiles were observed. In the subpopulation no significant differences in clinical endpoints were observed among the tertiles. Conclusion Lp-PLA2 activity levels at admission prior to pPCI in STEMI patients are not associated with the incidence of short and/or long-term clinical endpoints. Lp-PLA2 as an independent and clinically useful biomarker in the risk stratification of STEMI patients still remains to be proven.
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Affiliation(s)
- Pier Woudstra
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Peter Damman
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Wichert J. Kuijt
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Wouter J. Kikkert
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Maik J. Grundeken
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Peter M. van Brussel
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - An K. Stroobants
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan P. van Straalen
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Johan C. Fischer
- Department of Clinical Chemistry, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Karel T. Koch
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - José P. S. Henriques
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan J. Piek
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Jan G. P. Tijssen
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
| | - Robbert J. de Winter
- Heart Center, Academic Medical Center – University of Amsterdam, Amsterdam, The Netherlands
- * E-mail:
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Xin H, Gong HP, Cai SL, Ning XF, Liu S, Chen ZY, Lian ZX, Zhang R, Zhang QF, Kang WQ, Ge ZM. Elevated lipoprotein-associated phospholipase A2 is associated with progression of nonculprit lesions after percutaneous coronary intervention. TOHOKU J EXP MED 2014; 230:97-102. [PMID: 23774398 DOI: 10.1620/tjem.230.97] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme that hydrolyzes oxidized phospholipids to generate bioactive proatherogenic products. Nonculprit lesions have been assumed to contribute to the pathogenesis of recurrent acute coronary syndrome (ACS). The role of LP-PLA2 in the progression of nonculprit coronary lesions after successful percutaneous coronary intervention (PCI) remains unclear. Our study included 123 patients with ACS who underwent initial PCI and a long-term follow-up (mean interval, one year) with coronary angiography. Among them, 19 patients were diagnosed as the progression of nonculprit lesions, based on the presence of at least one of the following factors: (1) ≥ 10% reduction in the diameter of a preexisting ≥ 50% stenosis; (2) ≥ 30% reduction in the diameter of a < 50% stenosis; and (3) early-onset stenosis with ≥ 30% reduction in the diameter of a segment that was normal on the primary angiogram. Blood sampling was drawn from all patients at 12-14 hours after PCI. The ACS patients with progression had higher total cholesterol (4.47 ± 1.02 mmol/L vs. 3.59 ± 0.57 mmol/L, P < 0.05), higher levels of Lp-PLA2 activity (14.39 ± 6.13 nmol/min/ml vs. 8.86 ± 3.14 nmol/min/ml, P < 0.001) and a higher proportion of multi-vessel disease than those without progression. Multivariate logistic regression analysis showed that Lp-PLA2 activity (β = 0.024, P = 0.005) was an independent predictor for rapid progression of nonculprit coronary lesions. In conclusion, elevated Lp-PLA2 activity is associated with rapid progression of nonculprit coronary lesions in ACS patients who underwent PCI.
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Affiliation(s)
- Hui Xin
- Department of Cardiology, the Affiliated Hospital of Medical College, Qingdao University, Qingdao, Shandong, PR China.
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Hoogeveen RC, Ballantyne CM. PLAC™ test for identification of individuals at increased risk for coronary heart disease. Expert Rev Mol Diagn 2014; 5:9-14. [PMID: 15723587 DOI: 10.1586/14737159.5.1.9] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Recent advances in cardiovascular research point to a critical role of inflammatory processes in the etiology of cardiovascular disease. This has led to the discovery of novel inflammatory biomarkers, which may be useful as additional screening tools for the identification of individuals at increased risk of coronary heart disease. One such novel inflammatory biomarker is lipoprotein-associated phospholipase A(2). This review discusses the recent development of a US Food and Drug Administration-approved blood test for lipoprotein-associated phospholipase A(2) (PLAC test, diaDexus, Inc.) and its efficacy as a predictive biomarker of risk for cardiovascular disease. More specifically, the article addresses the potential target group most likely to benefit from this new screening test and provides a prospective scenario for its implementation.
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Affiliation(s)
- Ron C Hoogeveen
- Baylor College of Medicine, Section of Atherosclerosis & Lipoprotein Research, Department of Medicine, Center for Cardiovascular Disease Prevention, Houston, TX 77030, USA.
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Inflammatory biomarkers for predicting cardiovascular disease. Clin Biochem 2013; 46:1353-71. [PMID: 23756129 DOI: 10.1016/j.clinbiochem.2013.05.070] [Citation(s) in RCA: 112] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2012] [Revised: 05/27/2013] [Accepted: 05/30/2013] [Indexed: 02/07/2023]
Abstract
The pathology of cardiovascular disease (CVD) is complex; multiple biological pathways have been implicated, including, but not limited to, inflammation and oxidative stress. Biomarkers of inflammation and oxidative stress may serve to help identify patients at risk for CVD, to monitor the efficacy of treatments, and to develop new pharmacological tools. However, due to the complexities of CVD pathogenesis there is no single biomarker available to estimate absolute risk of future cardiovascular events. Furthermore, not all biomarkers are equal; the functions of many biomarkers overlap, some offer better prognostic information than others, and some are better suited to identify/predict the pathogenesis of particular cardiovascular events. The identification of the most appropriate set of biomarkers can provide a detailed picture of the specific nature of the cardiovascular event. The following review provides an overview of existing and emerging inflammatory biomarkers, pro-inflammatory cytokines, anti-inflammatory cytokines, chemokines, oxidative stress biomarkers, and antioxidant biomarkers. The functions of each biomarker are discussed, and prognostic data are provided where available.
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Rosenson RS, Stafforini DM. Modulation of oxidative stress, inflammation, and atherosclerosis by lipoprotein-associated phospholipase A2. J Lipid Res 2012; 53:1767-82. [PMID: 22665167 DOI: 10.1194/jlr.r024190] [Citation(s) in RCA: 115] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), also known as platelet-activating factor acetylhydrolase (PAF-AH), is a unique member of the phospholipase A(2) superfamily. This enzyme is characterized by its ability to specifically hydrolyze PAF as well as glycerophospholipids containing short, truncated, and/or oxidized fatty acyl groups at the sn-2 position of the glycerol backbone. In humans, Lp-PLA(2) circulates in active form as a complex with low- and high-density lipoproteins. Clinical studies have reported that plasma Lp-PLA(2) activity and mass are strongly associated with atherogenic lipids and vascular risk. These observations led to the hypothesis that Lp-PLA(2) activity and/or mass levels could be used as biomarkers of cardiovascular disease and that inhibition of the activity could offer an attractive therapeutic strategy. Darapladib, a compound that inhibits Lp-PLA(2) activity, is anti-atherogenic in mice and other animals, and it decreases atherosclerotic plaque expansion in humans. However, disagreement continues to exist regarding the validity of Lp-PLA(2) as an independent marker of atherosclerosis and a scientifically justified target for intervention. Circulating Lp-PLA(2) mass and activity are associated with vascular risk, but the strength of the association is reduced after adjustment for basal concentrations of the lipoprotein carriers with which the enzyme associates. Genetic studies in humans harboring an inactivating mutation at this locus indicate that loss of Lp-PLA(2) function is a risk factor for inflammatory and vascular conditions in Japanese cohorts. Consistently, overexpression of Lp-PLA(2) has anti-inflammatory and anti-atherogenic properties in animal models. This thematic review critically discusses results from laboratory and animal studies, analyzes genetic evidence, reviews clinical work demonstrating associations between Lp-PLA(2) and vascular disease, and summarizes results from animal and human clinical trials in which administration of darapladib was tested as a strategy for the management of atherosclerosis.
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Li L, Qi L, Lv N, Gao Q, Cheng Y, Wei Y, Ye J, Yan X, Dang A. Association between lipoprotein-associated phospholipase A2 gene polymorphism and coronary artery disease in the Chinese Han population. Ann Hum Genet 2011; 75:605-11. [PMID: 21834908 DOI: 10.1111/j.1469-1809.2011.00666.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
The role of the lipoprotein-associated phospholipase A(2) gene (PLA2G7) in atherosclerosis remains controversial. We investigated the frequency of single-nucleotide polymorphisms (SNPs) of PLA2G7 (rs16874954 and rs1051931) and their association with coronary artery disease (CAD) in a cohort of CAD patients (n= 806) and age-matched healthy controls (n= 482) in the Chinese Han population. The VF and FF genotype of rs16874954 was significantly more frequent in the CAD patients (13.5%) than in the controls (9.3%, P= 0.024). The association remained after adjustment for age, gender, body mass index, smoking status, history of diabetes, positive family history of CAD, high-density lipoprotein cholesterol, and triglyceride (OR = 1.922; 95% CI [1.146-3.224]; P= 0.013). There was no significant difference in the frequency of any genotype of rs1051931 between the two groups. However, the frequency of the allele V379 was significantly greater in CAD patients with a history of myocardial infarction (MI) than in those without a history of MI (18.7% and 14.8%, P= 0.038). We conclude that there is significant association between the rs16874954 mutation and CAD in the Chinese Han population. The expression of rs1051931 variant in CAD patients may entail increased risk of MI.
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Affiliation(s)
- Liyun Li
- Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
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Lee KK, Fortmann SP, Varady A, Fair JM, Go AS, Quertermous T, Hlatky MA, Iribarren C. Racial variation in lipoprotein-associated phospholipase A₂ in older adults. BMC Cardiovasc Disord 2011; 11:38. [PMID: 21714927 PMCID: PMC3146402 DOI: 10.1186/1471-2261-11-38] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2010] [Accepted: 06/29/2011] [Indexed: 01/27/2023] Open
Abstract
Background Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a predictor of cardiovascular events that has been shown to vary with race. The objective of this study was to examine factors associated with this racial variation. Methods We measured Lp-PLA2 mass and activity in 714 healthy older adults with no clinical coronary heart disease and not taking dyslipidemia medication. We evaluated the association between race and Lp-PLA2 mass and activity levels after adjustment for various covariates using multivariable linear regression. These covariates included age, sex, diabetes, hypertension, body mass index, lipid measurements, C-reactive protein, smoking status, physical activity, diet, income, and education level. We further examined genetic covariates that included three single nucleotide polymorphisms shown to be associated with Lp-PLA2 activity levels. Results The mean age was 66 years. Whites had the highest Lp-PLA2 mass and activity levels, followed by Hispanics and Asians, and then African-Americans; in age and sex adjusted analyses, these differences were significant for each non-White race as compared to Whites (p < 0.0001). For example, African-Americans were predicted to have a 55.0 ng/ml lower Lp-PLA2 mass and 24.7 nmol/ml-min lower activity, compared with Whites, independent of age and sex (p < 0.0001). After adjustment for all covariates, race remained significantly correlated with Lp-PLA2 mass and activity levels (p < 0.001) with African-Americans having 44.8 ng/ml lower Lp-PLA2 mass and 17.3 nmol/ml-min lower activity compared with Whites (p < 0.0001). Conclusion Biological, lifestyle, demographic, and select genetic factors do not appear to explain variations in Lp-PLA2 mass and activity levels between Whites and non-Whites, suggesting that Lp-PLA2 mass and activity levels may need to be interpreted differently for various races.
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Affiliation(s)
- Keane K Lee
- Department of Health Research and Policy, Stanford University School of Medicine, HRP Redwood Building, Stanford, CA 94305-5405, USA.
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Jang Y, Waterworth D, Lee JE, Song K, Kim S, Kim HS, Park KW, Cho HJ, Oh IY, Park JE, Lee BS, Ku HJ, Shin DJ, Lee JH, Jee SH, Han BG, Jang HY, Cho EY, Vallance P, Whittaker J, Cardon L, Mooser V. Carriage of the V279F null allele within the gene encoding Lp-PLA₂ is protective from coronary artery disease in South Korean males. PLoS One 2011; 6:e18208. [PMID: 21490708 PMCID: PMC3071750 DOI: 10.1371/journal.pone.0018208] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2011] [Accepted: 02/22/2011] [Indexed: 01/28/2023] Open
Abstract
Background The Asia-specific PLA2G7 994G-T transversion leads to V279F substitution within the lipoprotein-associated phospholipase-A2 (Lp-PLA2) and to absence of enzyme activity in plasma. This variant offers a unique natural experiment to assess the role of Lp-PLA2 in the pathogenesis of coronary artery disease (CAD) in humans. Given conflicting results from mostly small studies, a large two-stage case-control study was warranted. Methodology/Principal Findings PLA2G7 V279F genotypes were initially compared in 2890 male cases diagnosed with CAD before age 60 with 3128 male controls without CAD at age 50 and above and subsequently in a second independent male dataset of 877 CAD cases and 1230 controls. In the first dataset, the prevalence of the 279F null allele was 11.5% in cases and 12.8% in controls. After adjustment for age, body mass index, diabetes, smoking, glucose and lipid levels, the OR (95% CI) for CAD for this allele was 0.80 (0.66–0.97, p = 0.02). The results were very similar in the second dataset, despite lower power, with an allele frequency of 11.2% in cases and 12.5% in controls, leading to a combined OR of 0.80 (0.69–0.92), p = 0.002. The magnitude and direction of this genetic effect were fully consistent with large epidemiological studies on plasma Lp-PLA2 activity and CAD risk. Conclusions Natural deficiency in Lp-PLA2 activity due to carriage of PLA2G7 279F allele protects from CAD in Korean men. These results provide evidence for a causal relationship between Lp-PLA2 and CAD, and support pharmacological inhibition of this enzyme as an innovative way to prevent CAD.
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Affiliation(s)
- Yangsoo Jang
- Division of Cardiology, Cardiovascular Genome Center, Yonsei University College of Medicine, Yonsei, South Korea
| | - Dawn Waterworth
- Genetics Division, Medicine Discovery and Development, Research and Development, GlaxoSmithKline, Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
- * E-mail:
| | | | - Kijoung Song
- Genetics Division, Medicine Discovery and Development, Research and Development, GlaxoSmithKline, Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
| | | | - Hyo-Soo Kim
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Kyung Woo Park
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Hyun-Jai Cho
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Il-Young Oh
- Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital, Seoul, South Korea
| | - Jeong Euy Park
- Division of Cardiovascular Disease, Samsung Medical Center, Sung Kyun Kwan University, Seoul, South Korea
| | - Bok-Soo Lee
- Division of Cardiovascular Disease, Samsung Medical Center, Sung Kyun Kwan University, Seoul, South Korea
| | - Hyo Jeong Ku
- Division of Cardiovascular Disease, Samsung Medical Center, Sung Kyun Kwan University, Seoul, South Korea
| | - Dong-Jik Shin
- Division of Cardiology, Cardiovascular Genome Center, Yonsei University College of Medicine, Yonsei, South Korea
| | - Jong Ho Lee
- Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, South Korea
| | - Sun Ha Jee
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul, South Korea
| | - Bok-Ghee Han
- Center for Genome Science, National Institute of Health, Seoul, South Korea
| | | | | | - Patrick Vallance
- Medicine Discovery and Development, Research and Development, GlaxoSmithKline Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
| | - John Whittaker
- Genetics Division, Medicine Discovery and Development, Research and Development, GlaxoSmithKline, Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
| | - Lon Cardon
- Genetics Division, Medicine Discovery and Development, Research and Development, GlaxoSmithKline, Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
| | - Vincent Mooser
- Genetics Division, Medicine Discovery and Development, Research and Development, GlaxoSmithKline, Philadelphia, Pennsylvania, United States of America and Greenford, United Kingdom
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Derbent A, Kargili A, Koca C, Gümüş Iİ, Sevgili S, Simavli S, Karakurt F, Turhan NÖ. Serum platelet-activating factor acetylhydrolase activity: relationship with metabolic syndrome in women with history of gestational diabetes mellitus. Gynecol Endocrinol 2011; 27:128-33. [PMID: 20504094 DOI: 10.3109/09513590.2010.487612] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The aim of this study was to evaluate plasma platelet-activating factor acetylhydrolase (PAF-AH) activity in euglycaemic women with history of gestational diabetes (GDM), and to explore whether this activity is associated with metabolic syndrome (MS) in this group of women. METHODS The cross-sectional study included 36 women with history of GDM and 40 women with history of normal glucose tolerance in pregnancy (control group). RESULTS Compared to the controls, the GDM group had significantly higher mean values for serum glucose, insulin, HOMA-IR, triglyceride, GGT and plasma PAF-AH activity, and a statistically higher prevalence of MS. Within the GDM group, women diagnosed with MS had significantly higher PAF-AH activity than those without MS (p=0.002). CONCLUSION This is the first study to have shown that plasma PAF-AH activity and GGT levels may be significant for evaluating atherosclerosis risk and metabolic hepatic damage in women with history of GDM.
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Affiliation(s)
- Aysel Derbent
- Department of Obstetrics and Gynecology, Fatih University School of Medicine, Ankara, Turkey.
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Mallat Z, Lambeau G, Tedgui A. Lipoprotein-associated and secreted phospholipases A₂ in cardiovascular disease: roles as biological effectors and biomarkers. Circulation 2010; 122:2183-200. [PMID: 21098459 DOI: 10.1161/circulationaha.110.936393] [Citation(s) in RCA: 128] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Affiliation(s)
- Ziad Mallat
- INSERM, Paris-Cardiovascular Research Center, Université Paris Descartes, UMR, Paris, France
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Wang Q, Hao Y, Mo X, Wang L, Lu X, Huang J, Cao J, Li H, Gu D. PLA2G7 gene polymorphisms and coronary heart disease risk: A meta-analysis. Thromb Res 2010; 126:498-503. [DOI: 10.1016/j.thromres.2010.09.009] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2010] [Revised: 07/22/2010] [Accepted: 09/08/2010] [Indexed: 12/18/2022]
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Zheng GH, Chen HY, Xiong SQ, Chu JF. Lipoprotein-associated phospholipase A2 gene V279F polymorphisms and coronary heart disease: a meta-analysis. Mol Biol Rep 2010; 38:4089-99. [PMID: 21107710 DOI: 10.1007/s11033-010-0529-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2010] [Accepted: 11/15/2010] [Indexed: 01/04/2023]
Abstract
Lipoprotein-associated phospholipase A2 (LP-PLA2) may play an important role in the pathophysiology of coronary heart disease (CHD). The polymorphism of LP-PLA2 gene caused LP-PLA2 enzyme activity depressing or lost. But there is not a definite conclusion for the association of between the LP-PLA2 gene polymorphism and CHD risk. To assess the relationship between LP-PLA2 gene V279F polymorphism and CHD, a comprehensive Meta-analysis was performed. All the case-control studies evaluating the association of between the LP-PLA2 gene V279F polymorphism and CHD risk were identified. Seven case-control studies involving 3,614 patients with CHD and 4,334 controls were included. The crude odds ratios (ORs) of meta-analysis under the different gene model were not significant. But in the stratified analysis by study size, ethnicity, cases definition, and source of controls under the additive model, the association was evident in ethnicity for Japanese group (OR=1.38, 95%CI=1.22-1.56), cases definition for MI (OR=1.22, 95%CI=1.01-1.49), source of controls for the based-hospital (OR=1.42, 95%CI=1.24-1.59). These data suggested that the V279F polymorphism in LP-PLA2 gene may contribute to CHD development. But there is necessary that more well-designed large studies are required for the validation of this association.
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Affiliation(s)
- Guo-Hua Zheng
- The Centre of Evidence Based Medicine, Academy of Integrative Medicine, Fujian University of Traditional Chinese Medicine, No 1 Huatuo road, Shangjie University Town, Fuzhou, China.
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PLA2G7 genotype, lipoprotein-associated phospholipase A2 activity, and coronary heart disease risk in 10 494 cases and 15 624 controls of European Ancestry. Circulation 2010; 121:2284-93. [PMID: 20479152 DOI: 10.1161/circulationaha.109.923383] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Higher lipoprotein-associated phospholipase A(2)(Lp-PLA2) activity is associated with increased risk of coronary heart disease (CHD), making Lp-PLA2 a potential therapeutic target. PLA2G7 variants associated with Lp-PLA2 activity could evaluate whether this relationship is causal. METHODS AND RESULTS A meta-analysis including a total of 12 studies (5 prospective, 4 case-control, 1 case-only, and 2 cross-sectional studies; n=26 118) was undertaken to examine the association of the following: (1) Lp-PLA2 activity versus cardiovascular biomarkers and risk factors and CHD events (2 prospective studies; n=4884); (2) PLA2G7 single-nucleotide polymorphisms and Lp-PLA2 activity (3 prospective, 2 case-control, 2 cross-sectional studies; up to n=6094); and (3) PLA2G7 single-nucleotide polymorphisms and angiographic coronary artery disease (2 case-control, 1 case-only study; n=4971 cases) and CHD events (5 prospective, 2 case-control studies; n=5523). Lp-PLA2 activity correlated with several CHD risk markers. Hazard ratios for CHD events for the top versus bottom quartile of Lp-PLA2 activity were 1.61 (95% confidence interval, 1.31 to 1.99) and 1.17 (95% confidence interval, 0.91 to 1.51) after adjustment for baseline traits. Of 7 single-nucleotide polymorphisms, rs1051931 (A379V) showed the strongest association with Lp-PLA2 activity, with VV subjects having 7.2% higher activity than AAs. Genotype was not associated with risk markers, angiographic coronary disease (odds ratio, 1.03; 95% confidence interval, 0.80 to 1.32), or CHD events (odds ratio, 0.98; 95% confidence interval, 0.82 to 1.17). CONCLUSIONS Unlike Lp-PLA2 activity, PLA2G7 variants associated with modest effects on Lp-PLA2 activity were not associated with cardiovascular risk markers, coronary atheroma, or CHD. Larger association studies, identification of single-nucleotide polymorphisms with larger effects, or randomized trials of specific Lp-PLA2 inhibitors are needed to confirm or refute a contributory role for Lp-PLA2 in CHD.
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Anuurad E, Ozturk Z, Enkhmaa B, Pearson TA, Berglund L. Association of lipoprotein-associated phospholipase A2 with coronary artery disease in African-Americans and Caucasians. J Clin Endocrinol Metab 2010; 95:2376-83. [PMID: 20194707 PMCID: PMC2869550 DOI: 10.1210/jc.2009-2498] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2009] [Accepted: 02/04/2010] [Indexed: 01/28/2023]
Abstract
CONTEXT Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) is bound predominately to low-density lipoprotein and has been implicated as a risk factor for coronary artery disease (CAD). OBJECTIVE We investigated the association between Lp-PLA(2) and CAD in a biethnic African-American and Caucasian population. DESIGN Lp-PLA(2) mass, activity, and index, an integrated measure of mass and activity, and other cardiovascular risk factors were determined in 224 African-Americans and 336 Caucasians undergoing coronary angiography. MAIN OUTCOME MEASURES We assessed the distribution of Lp-PLA(2) levels and determined the predictive role of Lp-PLA(2) as a risk factor for CAD. RESULTS Levels of Lp-PLA(2) mass and activity were higher among Caucasians compared with African-Americans (293 +/- 75 vs. 232 +/- 76 ng/ml, P < 0.001 for mass and 173 +/- 41 vs. 141 +/- 39 nmol/min/ml, P < 0.001 for activity, respectively). However, Lp-PLA(2) index was similar in the two groups (0.61 +/- 0.17 vs. 0.64 +/- 0.19, P = NS). In both ethnic groups, Lp-PLA(2) activity and index was significantly higher among subjects with CAD. African-American subjects with CAD had significantly higher Lp-PLA(2) index than corresponding Caucasian subjects (0.69 +/- 0.20 vs. 0.63 +/- 0.18, P = 0.028). In multivariate regression analyses, after adjusting for other risk factors, Lp-PLA(2) index was independently (odds ratio 6.7, P = 0.047) associated with CAD in African-Americans but not Caucasians. CONCLUSIONS Lp-PLA(2) activity and index was associated with presence of CAD among African-Americans and Caucasians undergoing coronary angiography. The findings suggest an independent impact of vascular inflammation among African-Americans as contributory to CAD risk and underscore the importance of Lp-PLA(2) as a cardiovascular risk factor.
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Affiliation(s)
- Erdembileg Anuurad
- Department of Medicine, University of California, Davis, California 95817, USA
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Enkhmaa B, Anuurad E, Zhang W, Pearson TA, Berglund L. Association of Lp-PLA(2) activity with allele-specific Lp(a) levels in a bi-ethnic population. Atherosclerosis 2010; 211:526-30. [PMID: 20444451 DOI: 10.1016/j.atherosclerosis.2010.03.021] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2009] [Revised: 02/24/2010] [Accepted: 03/10/2010] [Indexed: 11/19/2022]
Abstract
OBJECTIVES Lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) and lipoprotein(a) [Lp(a)] have been implicated as cardiovascular disease risk factors, and are differentially regulated across ethnicity. We investigated the association between Lp-PLA(2) activity and allele-specific apolipoprotein(a) [apo(a)] levels in a bi-ethnic population. METHODS Lp-PLA(2) activity, Lp(a) and allele-specific apo(a) levels were determined in 224 African Americans and 336 Caucasians. RESULTS Lp-PLA(2) activity level was higher among Caucasians compared to African Americans (173 + or - 41 nmol/min/ml vs. 141 + or - 39 nmol/min/ml, P<0.001), and positively associated with Lp(a), total and LDL cholesterol, triglyceride, apolipoprotein B-100, and negatively with HDL cholesterol levels in both ethnic groups. The association between Lp-PLA(2) activity and Lp(a) was stronger among African Americans compared to Caucasians (R=0.238, beta(1)=3.48, vs. R=0.111, beta(1)=1.93, respectively). The Lp-PLA(2) activity level was significantly associated with allele-specific apo(a) levels for smaller (<26 K4 repeats) apo(a) sizes in both ethnic groups (P=0.015 for African Americans, P=0.038 for Caucasians). In contrast, for larger (>26 K4 repeats) apo(a) sizes, high Lp-PLA(2) activity levels were associated with higher allele-specific apo(a) levels in African Americans (P=0.009), but not in Caucasians. CONCLUSION The association between Lp-PLA(2) activity and allele-specific apo(a) levels differs across African American-Caucasian ethnicity.
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Affiliation(s)
- Byambaa Enkhmaa
- Department of Medicine, University of California, Davis, CA, USA
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Effects of V279F in the Lp-PLA(2) gene on markers of oxidative stress and inflammation in Koreans. Clin Chim Acta 2010; 411:486-93. [PMID: 20080080 DOI: 10.1016/j.cca.2009.12.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2009] [Revised: 12/28/2009] [Accepted: 12/28/2009] [Indexed: 11/21/2022]
Abstract
BACKGROUND A single nucleotide polymorphism (SNP), V279F, in the lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) gene is known to influence enzyme activity. It is unclear whether Lp-PLA(2) exerts pro- or antiatherogenic effects in humans. We investigated the interplay between V279F, Lp-PLA(2) activity, oxidative stress and inflammation. METHODS We genotyped 2914 healthy Koreans (43-79years) for the Lp-PLA(2) V279F and measured anthropometric parameters, lipid profile, fatty acid composition, lipid peroxides, inflammatory markers and Lp-PLA(2) levels. RESULTS Lp-PLA(2) activity was 24% lower in V/F subjects (n=641) than in those with the V/V genotype (n=2227). Enzyme activity was undetectable in F/F subjects. Lp-PLA(2) activity was positively correlated with LDL-cholesterol (r=0.134, P<0.001), ox-LDL (r=0.064, P<0.01), 8-epi-PGF(2alpha) (r=0.198, P<0.001), free fatty acid (r=0.082, P<0.001), and fibrinogen (r=0.112, P<0.01) levels. Additionally, ox-LDL, 8-epi-PGF(2alpha), free fatty acid, and fibrinogen levels were positively correlated with hs-CRP. V279F was associated with LDL-cholesterol and arachidonic acid (AA) in serum phospholipid. F/F subjects had lower LDL-cholesterol than V/V subjects (V/V: 120.9+/-0.69, V/F: 119.4+/-1.26, F/F: 109.2+/-4.84mg/dl, P=0.025). A significant association between the F/F genotype and increasing AA in serum phospholipids was found in subjects with high LDL-cholesterol (> or =130mg/dl) (P=0.003) but not in those with low LDL-cholesterol (<130mg/dl). F/F subjects in the high LDL-cholesterol group had CRP concentrations about three times higher than those with V/V or V/F genotypes (V/V: 1.25+/-0.09, V/F: 0.97+/-0.12, F/F: 3.20+/-0.88mg/dl, P<0.001). CONCLUSIONS The recessive effects of Lp-PLA(2) V279F on LDL-cholesterol and significant correlations between Lp-PLA(2) activity and LDL-cholesterol, 8-epi-PGF(2alpha) and fibrinogen support a pro-oxidative or pro-atherogenic role for this enzyme. Paradoxically, the combination of the complete deficiency of Lp-PLA(2) activity and high LDL-cholesterol enhanced lipid peroxidation and inflammation.
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Functional Consequences of Mutations and Polymorphisms in the Coding Region of the PAF Acetylhydrolase (PAF-AH) Gene. Pharmaceuticals (Basel) 2009; 2:94-117. [PMID: 27713227 PMCID: PMC3978535 DOI: 10.3390/ph2030094] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2009] [Revised: 11/10/2009] [Accepted: 11/19/2009] [Indexed: 12/03/2022] Open
Abstract
In the past several years a number of alterations in the PAF-AH/PLA2G7/LpPLA2 gene have been described. These include inactivating mutations, polymorphisms in the coding region, and other genetic changes located in promoter and intronic regions of the gene. The consequences associated with these genetic variations have been evaluated from different perspectives, including in vitro biochemical and molecular studies and clinical analyses in human subjects. This review highlights the current state of the field and suggests new approaches that can be used to evaluate functional consequences associated with mutations and polymorphisms in the PAF-AH gene.
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Miwa Y, Kamide K, Takiuchi S, Yoshii M, Horio T, Tanaka C, Banno M, Miyata T, Kawano Y. Association of PLA2G7 polymorphisms with carotid atherosclerosis in hypertensive Japanese. Hypertens Res 2009; 32:1112-8. [DOI: 10.1038/hr.2009.151] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Ali M, Madjid M. Lipoprotein-associated phospholipase A2: a cardiovascular risk predictor and a potential therapeutic target. Future Cardiol 2009; 5:159-73. [DOI: 10.2217/14796678.5.2.159] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2), present in the circulation and in atherosclerotic plaque, is an inflammatory marker with potential use as a predictor of cardiovascular risk and as a therapeutic target. Although Lp-PLA2 is associated with both LDL and HDL, it is important to determine whether Lp-PLA2 has a predominantly pro- or anti-atherogenic effect. Increasing evidence suggests a proatherogenic role for Lp-PLA2. ©iEpidemiologic and clinical evidence suggests Lp-PLA2 is an independent predictor of risk and may be superior to other inflammatory markers owing to its specificity and minimal biovariation. Lp-PLA2 inhibitors currently being investigated in clinical trials are promising novel anti-inflammatory agents with a specificity for the vascular bed and a potential for decreasing plaque vulnerability.
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Affiliation(s)
- Muzammil Ali
- Texas Heart Institute, 6770 Bertner Ave, MC 2-255, Houston, TX 77030, USA
| | - Mohammad Madjid
- Texas Heart Institute at St Luke’s Episcopal Hospital, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Hoffmann MM, Winkler K, Renner W, Winkelmann BR, Seelhorst U, Wellnitz B, Boehm BO, März W. Genetic variants and haplotypes of lipoprotein associated phospholipase A2 and their influence on cardiovascular disease (The Ludwigshafen Risk and Cardiovascular Health Study). J Thromb Haemost 2009; 7:41-8. [PMID: 18983494 DOI: 10.1111/j.1538-7836.2008.03216.x] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND There is increasing evidence that lipoprotein-associated phospholipase A2 (LpPLA2) is associated with cardiovascular disease. However, it is still unclear whether LpPLA2 is simply a marker or has a causal role as either a pro- or anti-atherogenic factor. METHODS We analyzed the association of five polymorphisms (-1357G>A, -403T>C, Arg92His, Ile198Thr, Ala379Val) and related haplotypes at the PLA2G7 locus with angiographic coronary artery disease (CAD), plasma LpPLA2 activity, and long-term survival in 3234 patients scheduled for coronary angiography. RESULTS The promoter variant -403C and His(92) were associated with a decrease and Val(379) with an increase in plasma LpPLA2 activity. Both coding variants revealed a clear gene-dose effect. Interestingly, the rare Thr(198) allele, which was not associated with any change in plasma LpPLA2 activity, was more frequent in subjects without CAD (P = 0.009), with an adjusted odds ratio for CAD of 0.69 (95% CI: 0.49-0.96; P = 0.029). None of the analyzed variants showed any robust association with all-cause or cardiovascular mortality. CONCLUSION Irrespective of the significant association between some variants with plasma LpPLA2 activity, it is still unclear whether these polymorphisms or haplotypes are associated with the risk and outcome of cardiovascular disease in Caucasians.
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Affiliation(s)
- M M Hoffmann
- Division of Clinical Chemistry, Department of Medicine, University Medical Center Freiburg, Freiburg, Germany.
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Hou L, Chen S, Yu H, Lu X, Chen J, Wang L, Huang J, Fan Z, Gu D. Associations of PLA2G7 gene polymorphisms with plasma lipoprotein-associated phospholipase A2 activity and coronary heart disease in a Chinese Han population: the Beijing atherosclerosis study. Hum Genet 2008; 125:11-20. [PMID: 19034521 DOI: 10.1007/s00439-008-0587-4] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2008] [Accepted: 11/06/2008] [Indexed: 12/31/2022]
Abstract
The human PLA2G7 gene encodes lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), an emerging risk factor for cardiovascular diseases. In the present study, seven single nucleotide polymorphisms (SNPs) in the PLA2G7 gene were genotyped in 827 patients with coronary heart disease (CHD), of which 512 were patients with myocardial infarction (MI), and 947 age- and gender-matched controls in a Chinese Han population. Plasma Lp-PLA(2) activity was measured in 416 randomly selected controls and 689 randomly selected CHD patients, including 423 MI patients. Lp-PLA(2) activity in CHD and MI cases was significantly higher (233.42+/-57.66 and 234.27+/-59.51 nmol ml(-1) min(-1), respectively) than in controls (211.47+/-58.61 nmol ml(-1) min(-1)). After adjusting for traditional risk factors by logistic regression, the odds ratios for CHD and MI per 1 standard deviation increment of Lp-PLA(2) activity were 1.27 (95% CI, 1.07-1.50) and 1.27 (95% CI, 1.05-1.54), respectively. Both single SNP analysis and haplotype analysis showed that the V279F and I198T polymorphisms were significantly associated with the reduced Lp-PLA(2) activity, but neither was associated with increased CHD risk. Both univariate and multivariate analyses, adjusting effects of conventional factors, indicated that the rs13210554 T allele increased the risk of MI in this Chinese Han population. In summary, an independent association of increased plasma Lp-PLA(2) activity with CHD and MI existed in this Chinese Han Population. Although V279F and I198T mutations significantly decreased the activity of Lp-PLA(2), only the promoter rs13210554 polymorphism was associated with MI. Lp-PLA(2) activity appears to influence the CHD and MI risk in Chinese Han population.
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Affiliation(s)
- Liping Hou
- Department of Evidence Based Medicine and Division of Population Genetics, Cardiovascular Institute and Fu Wai Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, 167 Beilishi Road, 100037 Beijing, China
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Stafforini DM. Biology of platelet-activating factor acetylhydrolase (PAF-AH, lipoprotein associated phospholipase A2). Cardiovasc Drugs Ther 2008; 23:73-83. [PMID: 18949548 DOI: 10.1007/s10557-008-6133-8] [Citation(s) in RCA: 161] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/31/2008] [Accepted: 08/06/2008] [Indexed: 12/26/2022]
Abstract
INTRODUCTION This article is focused on platelet-activating factor acetylhydrolase (PAF-AH), a lipoprotein bound, calcium-independent phospholipase A(2) activity also referred to as lipoprotein-associated phospholipase A(2) or PLA(2)G7. 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. DISCUSSION 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. This mechanism is likely responsible for the observed up-regulation of PAF-AH during atherosclerosis and suggests that increased expression of this enzyme is a physiological response to inflammatory stimuli. Administration of recombinant forms of PAF-AH attenuate inflammation in a variety of experimental models. Conversely, genetic deficiency of PAF-AH in defined human populations increases the severity of atherosclerosis and other syndromes. Recent advances pointing to an interplay among oxidized phospholipid substrates, Lp(a), and PAF-AH could hold the key to a number of unanswered questions.
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Affiliation(s)
- Diana M Stafforini
- Huntsman Cancer Institute and Department of Internal Medicine, University of Utah, 2000 Circle of Hope, Suite 3364, Salt Lake City, UT 84112-5550, USA.
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The role of phospholipid oxidation products in inflammatory and autoimmune diseases: evidence from animal models and in humans. Subcell Biochem 2008; 49:325-50. [PMID: 18751917 DOI: 10.1007/978-1-4020-8830-8_12] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Since the discovery of oxidized phospholipids (OxPL) and their implication as modulators of inflammation in cardiovascular disease, roles for these lipid oxidation products have been suggested in many other disease settings. Lipid oxidation products accumulate in inflamed and oxidatively damaged tissue, where they are derived from oxidative modification of lipoproteins, but also from membranes of cells undergoing apoptosis. Thus, increased oxidative stress as well as decreased clearance of apoptotic cells has been implied to contribute to accumulation of OxPL in chronically inflamed tissues.A central role for OxPL in disease states associated with dyslipedemia, including atherosclerosis, diabetes and its complications, metabolic syndrome, and renal insufficiency, as well as general prothrombotic states, has been proposed. In addition, in organs which are constantly exposed to oxidative stress, including lung, skin, and eyes, increased levels of OxPL are suggested to contribute to inflammatory conditions. Moreover, accumulation of OxPL causes general immunmodulation and may lead to autoimmune diseases. Evidence is accumulating that OxPL play a role in lupus erythematosus, antiphospholipid syndrome, and rheumatoid arthritis. Last but not least, a role for OxPL in neurological disorders including multiple sclerosis (MS), Alzheimer's and Parkinson's disease has been suggested.This chapter will summarize recent findings obtained in animal models and from studies in humans that indicate that formation of OxPL represents a general mechanism that may play a major role in chronic inflammatory and autoimmune diseases.
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Brilakis ES, Khera A, McGuire DK, See R, Banerjee S, Murphy SA, de Lemos JA. Influence of race and sex on lipoprotein-associated phospholipase A2 levels: observations from the Dallas Heart Study. Atherosclerosis 2008; 199:110-5. [PMID: 18061193 PMCID: PMC2495009 DOI: 10.1016/j.atherosclerosis.2007.10.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2007] [Revised: 09/30/2007] [Accepted: 10/15/2007] [Indexed: 11/21/2022]
Abstract
AIMS Most lipoprotein-associated phospholipase A2 (Lp-PLA2) studies included mainly white men. We sought to determine whether Lp-PLA2 levels differ according to race and sex. METHODS Lp-PLA2 mass and activity were measured in 3332 subjects age 30-65 participating in the Dallas Heart Study, a multiethnic, population-based, probability sample. Lp-PLA2 levels were compared between different race and sex groups. RESULTS Mean age was 45+/-9 years and 44% were men; 30% were white, 17% hispanic, and 53% black. Mean Lp-PLA2 activity and mass were 146+/-40 nmol/min/mL and 191+/-60 ng/mL, respectively. Lp-PLA2 activity was lower in women compared with men (134+/-35 vs. 161+/-40, p=0.001) and was lowest in black (136+/-38), intermediate in hispanic (151+/-36), and highest in white subjects (161+/-39) (trend p=0.0001). In multivariable linear regression models, after adjusting for age, body mass index (BMI), smoking, total, low-density lipoprotein (LDL) and high-density lipoprotein (HDL) cholesterol, triglycerides and high sensitivity C-reactive protein (hsCRP), Lp-PLA2 activity was 19 nmol/min/mL higher in men vs. women (p<0.001); compared with black subjects, adjusted Lp-PLA2 activity was 11 and 20 nmol/min/mL higher in white and hispanic subjects, respectively (both p<0.001). Similar race and sex differences were observed for Lp-PLA2 mass. CONCLUSION Race and sex independently influence Lp-PLA2 activity and mass. Thresholds to define Lp-PLA2 elevation may need to be sex and race specific.
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Affiliation(s)
- Emmanouil S Brilakis
- The Donald W. Reynolds Cardiovascular Clinical Research Center at the University of Texas Southwestern Medical Center in Dallas, TX, United States.
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El-Saed A, Sekikawa A, Zaky RW, Kadowaki T, Takamiya T, Okamura T, Edmundowicz D, Kita Y, Kuller LH, Ueshima H. Association of lipoprotein-associated phospholipase A2 with coronary calcification among American and Japanese men. J Epidemiol 2008; 17:179-85. [PMID: 18094516 PMCID: PMC3659786 DOI: 10.2188/jea.17.179] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BACKGROUND We have previously reported that the prevalence of coronary artery calcification (CAC) was substantially lower among Japanese than American men despite a less favorable profile of many traditional risk factors in Japanese men. To determine whether lipoprotein-associated phospholipase A2 (Lp-PLA2) levels are related to the difference in the prevalence of CAC between the two populations. METHODS A total of 200 men aged 40-49 years were examined: 100 residents in Allegheny County, Pennsylvania, United States, and 100 residents in Kusatsu City, Shiga, Japan. Coronary calcium score (CCS) was evaluated by electron-beam tomography, Lp-PLA2 levels, nuclear magnetic resonance (NMR) lipoprotein subclasses, and other factors were assessed in 2001-2002. RESULTS Lp-PLA2 levels were higher among American than Japanese men (Mean ± standard deviation 301.7 ± 82.6 versus 275.9 ± 104.7 ng/mL, respectively, p=0.06). Among all Japanese men and those with low density lipoprotein (LDL) cholesterol >130 mg/dL, there was an inverse association of the prevalence of CCS>0 with the fertile groups of Lp-PLA2 levels (p=0.08 and p=0.03, respectively). American men did not have any association between CCS>0 with the fertile groups of Lp-PLA2 (p=0.62). Although Lp-PLA2 among both populations correlated positively with LDL and total cholesterol, American and Japanese men had different correlations with NMR lipoprotein subclasses. Reported high odds ratio for CCS>0 among American compared to Japanese men was not reduced after adjusting for Lp-PLA2 levels. CONCLUSION Lp-PLA2 may have different mechanisms of action among American and Japanese men. Lp-PLA2 levels can not explain the observed CAC differences between the two populations.
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Affiliation(s)
- Aiman El-Saed
- Department of Epidemiology, Graduate School of Public Health. University of Pittsburgh, Pittsburgh, PA 15213, USA.
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Zhang SY, Shibata H, Karino K, Wang BY, Kobayashi S, Masuda J, Nabika T. Comprehensive evaluation of genetic and environmental factors influencing the plasma lipoprotein-associated phospholipase A2 activity in a Japanese population. Hypertens Res 2007; 30:403-9. [PMID: 17587752 DOI: 10.1291/hypres.30.403] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The lipoprotein-associated phospholipase A2 (Lp-PLA2) metabolizes oxidized phospholipids, generating lysophosphatidylcholine. The activity of the enzyme is known to be influenced largely by a single-nucleotide polymorphism, G994T, in the Lp-PLA2 gene. Interestingly, this polymorphism is much more prevalent in Japanese than Caucasians. The purpose of the current study was to evaluate the effects of the G994T, several environmental factors, and their interactions on the Lp-PLA2 activity in a large Japanese cohort. Participants (1,110 males and 908 females) of a health-screening examination were recruited for this study. Genotyping of the G994T was done using allele-specific polymerase chain reaction (PCR). The Lp-PLA2 activity was measured using commercial kits. The minor allele (994T) frequency of the polymorphism was 0.17 in this study, which was consistent with previous reports. According to the multivariate linear regression analysis, the G994T was the most potent factor influencing the enzyme activity (standardized beta=0.76), followed by the low-density lipoprotein cholesterol (LDL-C) level (standardized beta=0.32) and the sex (standardized beta=0.13). The LDL-C level showed a significant interaction with the G994T genotype. By contrast, no significant interaction was observed between the LDL-C level and the sex. These observations should provide useful information for future clinical and epidemiological evaluations of the Lp-PLA2 activity in cardiovascular diseases in Japanese.
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Affiliation(s)
- Shao-Yan Zhang
- Department of Epidemiology, Public Health College, Harbin Medical University, Harbin, PR China
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Garza CA, Montori VM, McConnell JP, Somers VK, Kullo IJ, Lopez-Jimenez F. Association between lipoprotein-associated phospholipase A2 and cardiovascular disease: a systematic review. Mayo Clin Proc 2007; 82:159-65. [PMID: 17290721 DOI: 10.4065/82.2.159] [Citation(s) in RCA: 113] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To estimate the association between plasma lipoprotein-associated phospholipase A2 (Lp-PLA2) levels and cardiovascular disease (CVD). METHODS We searched MEDLINE (January 1, 1985, through September 30, 2006), the Cochrane library (from inception through 2006), conference proceedings, and reference sections of obtained articles and contacted experts for unpublished studies. Eligible studies were cohorts with 1 year or more of follow-up or case-control designs that provided risk estimates for CVD according to blood levels of Lp-PLA2 that were unadjusted or adjusted for conventional CVD risk factors. We used random-effects meta-analysis to estimate the association between Lp-PLA2 and CVD risk and conducted preplanned subgroup analyses to identify risk-subgroup interactions that could explain between-study differences. RESULTS We found 14 eligible studies (N = 20,549 patients) that reported either Lp-PLA2 plasma activity (n = 5) or an immunoassay that measured the plasma concentration (n = 9). The meta-analytic estimate from the unadjusted odds ratio for the association between elevated Lp-PLA2 levels and CVD risk was 1.51 (95% confidence interval, 1.30-1.75) and from the odds ratio adjusted for conventional CVD risk factors was 1.60 (95% confidence interval, 1.36-1.89). Differences in study methods explained differences in results across studies. CONCLUSIONS Lipoprotein-associated phospholipase A2 is significantly associated with CVD. The risk estimate appears to be relatively unaffected by adjustment for conventional CVD risk factors. Measurement of Lp-PLA2 may be useful in CVD risk stratification. In addition, Lp-PLA2 may represent a potential therapeutic target for CVD risk reduction.
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Affiliation(s)
- Carolina A Garza
- Division of Cardiovascular Diseases, Mayo Clinic College of Medicine, Rochester, Minn 55905, USA
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MacRitchie AN, Gardner AA, Prescott SM, Stafforini DM. Molecular basis for susceptibility of plasma platelet-activating factor acetylhydrolase to oxidative inactivation. FASEB J 2007; 21:1164-76. [PMID: 17210780 DOI: 10.1096/fj.06-6743com] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Platelet-activating factor acetylhydrolase (PAF-AH) is a phospholipase A2 that inactivates potent lipid messengers, such as PAF and modified phospholipids generated in settings of oxidant stress. The catalytic activity of PAF-AH is sensitive to oxidants, a feature that may have pathological consequences. We report that peroxynitrite, an oxidant species generated after cellular activation, mediates oxidative inactivation of PAF-AH. We found that peroxynitrite inactivated and derivatized the recombinant protein and obtained evidence supporting a role for a methionine and two tyrosine residues in this process. We employed interspecies comparisons and site-directed mutagenesis and identified a role for M-117, and a smaller contribution of Y-307 and Y-335 as targets of oxidant attack using free and lipoprotein-associated recombinant proteins. M-117 is adjacent to W-115 and L-116, which are essential for association of PAF-AH with LDL. Oxidation of LDL-associated PAF-AH partially dissociated the enzyme from the particles. Similarly, oxidation of the purified enzyme in the absence of lipoproteins prevented subsequent association with LDL. These results provide new insights into the molecular mechanisms that mediate inactivation of PAF-AH in settings of oxidant stress and the consequences of oxidation on the ability of this enzyme to associate with LDL.
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Affiliation(s)
- Amy N MacRitchie
- Huntsman Cancer Institute, 2000 Cir. of Hope, University of Utah, Salt Lake City, UT 84112-5550, USA
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Abstract
Oxidative damage to lipids and proteins is an important component of atherosclerotic cardiovascular disease (CVD). Studies of oxidation-related molecules are helping to define atherosclerotic mechanisms, and measurements of circulating levels of specific oxidant compounds may improve cardiovascular risk assessment. The present article reviews accumulating data of selected oxidative biomarkers that support their role in providing diagnostic and/or prognostic information. For example, plasma levels of the enzyme myeloperoxidase, which generates the strong oxidizing agent hypochlorous acid, have been found to be correlated with risk for myocardial infarction and endothelial dysfunction. Elevated levels of lipoprotein-associated phospholipase A(2) are associated with coronary artery disease (CAD) and stroke. Oxidized phospholipids play an important role in atherosclerosis. Recent studies measuring circulating levels of oxidized phospholipids have suggested a strong association with CAD, plaque disruption, and response to 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitor ("statin") therapy. Isoprostanes correlate strongly with cardiovascular risk factors, but their role in risk prediction is less well defined. Future studies are expected to clarify the role of oxidative biomarkers in the diagnosis and prognosis of CVD and to determine their value in specific clinical populations.
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Affiliation(s)
- Sotirios Tsimikas
- Interventional Cardiology Program, Section of Vascular Medicine, Division of Cardiovascular Diseases, Department of Medicine, University of California-San Diego, La Jolla, California, USA.
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