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Li M, Wang Y, Yao Q, Liang Q, Zhang Y, Wang X, Li Q, Qiang W, Yang J, Shi B, He M. Association between Lipoprotein(a) and diabetic nephropathy in patients with type 2 diabetes. Front Endocrinol (Lausanne) 2024; 14:1337469. [PMID: 38288472 PMCID: PMC10822945 DOI: 10.3389/fendo.2023.1337469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Abstract
Background Diabetic nephropathy (DN) is one of the most prevalent and severe microvascular complications of type 2 diabetes (T2DM). However, little is currently known about the pathogenesis and its associated risk factors in DN. The present study aims to investigate the potential risk factors of DN in patients with T2DM. Methods A total of 6,993 T2DM patients, including 5,089 participants with DN and 1,904 without DN, were included in this cross-sectional study. Comparisons between the two groups (DN vs. non-DN) were carried out using Student's t-test, Mann-Whitney U-test, or Pearson's Chi-squared test. Spearman's correlation analyses were performed to assess the correlations of serum lipids and indicators of renal impairment. Logistic regression models were applied to assess the relationship between blood lipid indices and the presence of DN. Results T2DM patients with DN were older, and had a longer duration of diagnosed diabetes compared to those without DN. Of note, the DN patients also more likely develop metabolic disorders. Among all serum lipids, Lipoprotein(a) [Lp(a)] was the most significantly correlated indicators of renal impairment. Moreover, univariate logistic regression showed that elevated Lp(a) level was associated with an increased risk of DN. After adjusted for confounding factors, including age, gender, duration of T2DM, BMI, SBP, DBP and lipid-lowering drugs usage, Lp(a) level was independently positively associated with the risk of DN [odds ratio (OR):1.115, 95% confidence interval (CI): 1.079-1.151, P=6.06×10-11]. Conclusions Overall, we demonstrated that serum Lp(a) level was significantly positively associated with an increased risk of DN, indicating that Lp(a) may have the potential as a promising target for the diagnosis and treatment of diabetic nephropathy.
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Affiliation(s)
- Meng Li
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Yanjun Wang
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Qianqian Yao
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Qian Liang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Yuanyuan Zhang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Xin Wang
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Qian Li
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Wei Qiang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Jing Yang
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Bingyin Shi
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
| | - Mingqian He
- Department of Endocrinology, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
- Med-X Institute, Center for Immunological and Metabolic Diseases, The First Affiliated Hospital of Xi’an JiaoTong University, Xi’an, Shaanxi, China
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Lorey MB, Youssef A, Äikäs L, Borrelli M, Hermansson M, Assini JM, Kemppainen A, Ruhanen H, Ruuth M, Matikainen S, Kovanen PT, Käkelä R, Boffa MB, Koschinsky ML, Öörni K. Lipoprotein(a) induces caspase-1 activation and IL-1 signaling in human macrophages. Front Cardiovasc Med 2023; 10:1130162. [PMID: 37293282 PMCID: PMC10244518 DOI: 10.3389/fcvm.2023.1130162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Introduction Lipoprotein(a) (Lp(a)) is an LDL-like particle with an additional apolipoprotein (apo)(a) covalently attached. Elevated levels of circulating Lp(a) are a risk factor for atherosclerosis. A proinflammatory role for Lp(a) has been proposed, but its molecular details are incompletely defined. Methods and results To explore the effect of Lp(a) on human macrophages we performed RNA sequencing on THP-1 macrophages treated with Lp(a) or recombinant apo(a), which showed that especially Lp(a) induces potent inflammatory responses. Thus, we stimulated THP-1 macrophages with serum containing various Lp(a) levels to investigate their correlations with cytokines highlighted by the RNAseq, showing significant correlations with caspase-1 activity and secretion of IL-1β and IL-18. We further isolated both Lp(a) and LDL particles from three donors and then compared their atheroinflammatory potentials together with recombinant apo(a) in primary and THP-1 derived macrophages. Compared with LDL, Lp(a) induced a robust and dose-dependent caspase-1 activation and release of IL-1β and IL-18 in both macrophage types. Recombinant apo(a) strongly induced caspase-1 activation and IL-1β release in THP-1 macrophages but yielded weak responses in primary macrophages. Structural analysis of these particles revealed that the Lp(a) proteome was enriched in proteins associated with complement activation and coagulation, and its lipidome was relatively deficient in polyunsaturated fatty acids and had a high n-6/n-3 ratio promoting inflammation. Discussion Our data show that Lp(a) particles induce the expression of inflammatory genes, and Lp(a) and to a lesser extent apo(a) induce caspase-1 activation and IL-1 signaling. Major differences in the molecular profiles between Lp(a) and LDL contribute to Lp(a) being more atheroinflammatory.
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Affiliation(s)
- Martina B. Lorey
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
- Molecular and Integrative Biosciences, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
| | - Amer Youssef
- Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Lauri Äikäs
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Matthew Borrelli
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Martin Hermansson
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Julia M. Assini
- Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
- Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Aapeli Kemppainen
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Hanna Ruhanen
- Molecular and Integrative Biosciences, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
- Helsinki University Lipidomics Unit (HiLIPID), Helsinki Institute of Life Science (HiLIFE) and Biocenter Finland, Helsinki, Finland
| | - Maija Ruuth
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Sampsa Matikainen
- Helsinki Rheumatic Disease and Inflammation Research Group, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Petri T. Kovanen
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
| | - Reijo Käkelä
- Molecular and Integrative Biosciences, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
- Helsinki University Lipidomics Unit (HiLIPID), Helsinki Institute of Life Science (HiLIFE) and Biocenter Finland, Helsinki, Finland
| | - Michael B. Boffa
- Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
- Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Marlys L. Koschinsky
- Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Katariina Öörni
- Atherosclerosis Research Laboratory, Wihuri Research Institute, Helsinki, Finland
- Molecular and Integrative Biosciences, Faculty of Biological and Environmental Sciences, University of Helsinki, Helsinki, Finland
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Wang A, Zhang S, Li Y, Zhu F, Xie B. Study on the relationship between lipoprotein (a) and diabetic kidney disease. J Diabetes Complications 2023; 37:108378. [PMID: 36549039 DOI: 10.1016/j.jdiacomp.2022.108378] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Revised: 11/29/2022] [Accepted: 12/01/2022] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Little is currently known about the role of lipid metabolism in diabetic kidney disease (DKD), warranting further study. The present study sought to investigate the correlation between lipid metabolism and renal function as well as renal pathological grade/score in DKD patients. METHODS A total of 224 patients diagnosed with DKD by pathological examination were retrospectively analyzed, of which 74 patients were further evaluated by DKD pathological grade/score. ANOVA was used to investigate serum lipoprotein (a) [Lp (a)] levels in DKD patients with different chronic kidney disease (CKD) stages. Spearman correlation analysis was used to evaluate the relationship between Lp (a) and renal function-related indicators. The DKD pathological grade/score was also evaluated with this method. The receiver operating characteristic (ROC) curve was used to analyze the value of Lp (a) in assessing renal function and pathological changes. RESULTS There were significant differences in Lp (a) levels among different CKD stages (H = 17.063, p = 0.002) and glomerular grades (H = 12.965, p = 0.005). Lp (a) levels correlated with serum creatinine (p = 0.000), blood urea nitrogen (p = 0.000), estimated glomerular filtration rate (p = 0.000), 24-h proteinuria (24hUPro, p = 0.000), urine microalbumin (p = 0.000), urine albumin creatinine ratio (p = 0.000), glomerular basement membrane thickness (p = 0.003), and glomerular grade (p = 0.039). ROC curve demonstrated good performance of Lp (a) as an indicator to assess CKD stage 4-5 (AUC = 0.684, p = 0.000), 24hUPro > 3.5 g (AUC = 0.720, p = 0.000), and glomerular grade III-IV (AUC = 0.695, p = 0.012). CONCLUSIONS Elevated levels of Lp (a) are associated with decreased GFR, increased proteinuria, and renal pathological progression, suggesting they could be used to monitor changes in DKD patients.
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Affiliation(s)
- Anni Wang
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People's Republic of China.
| | - Shaojie Zhang
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People's Republic of China
| | - Yayu Li
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People's Republic of China
| | - Fenggui Zhu
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People's Republic of China
| | - Bo Xie
- Hangzhou Hospital of Traditional Chinese Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, Tiyuchang Rd 453, Hangzhou 310007, People's Republic of China; Hangzhou Third People's Hospital, Hangzhou Third Hospital Affiliated to Zhejiang Chinese Medical University, Affiliated Hangzhou Dermatology Hospital, Zhejiang University School of Medicine, Westlake Ave 38, Hangzhou 310009, People's Republic of China.
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4
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Boffa MB. Beyond fibrinolysis: The confounding role of Lp(a) in thrombosis. Atherosclerosis 2022; 349:72-81. [DOI: 10.1016/j.atherosclerosis.2022.04.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2022] [Revised: 03/24/2022] [Accepted: 04/05/2022] [Indexed: 12/20/2022]
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Liu J, Li Y. Thrombosis associated with mycoplasma pneumoniae infection (Review). Exp Ther Med 2021; 22:967. [PMID: 34335909 PMCID: PMC8290426 DOI: 10.3892/etm.2021.10399] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 06/18/2021] [Indexed: 12/12/2022] Open
Abstract
Mycoplasma pneumoniae is a common pathogen causing respiratory infections in children and adults. In addition to respiratory diseases, Mycoplasma pneumoniae is also involved in numerous extrapulmonary diseases. Thrombosis is an extrapulmonary manifestation associated with Mycoplasma pneumoniae infection. In recent years, an increasing number of case reports have been published identifying thrombosis secondary to Mycoplasma pneumoniae infection. In the present study, the available relevant literature in English available on PubMed, Medline and Web of Science was consulted. The results of the present study demonstrated that in patients with thrombosis caused by Mycoplasma pneumoniae infection, some of the factors causing thrombosis are transient and some are due to hereditary thrombophilia. Following timely treatment, the majority of patients recovered completely but some patients had a poor prognosis. The present review focuses on the pathogenesis, clinical features, treatment and prognosis of this crucial issue, which contributes toward the understanding of the disease.
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Affiliation(s)
- Jingwei Liu
- Department of Pediatrics Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
| | - Yumei Li
- Department of Pediatrics Intensive Care Unit, The First Hospital of Jilin University, Changchun, Jilin 130021, P.R. China
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Lipoprotein(a) the Insurgent: A New Insight into the Structure, Function, Metabolism, Pathogenicity, and Medications Affecting Lipoprotein(a) Molecule. J Lipids 2020; 2020:3491764. [PMID: 32099678 PMCID: PMC7016456 DOI: 10.1155/2020/3491764] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Accepted: 08/17/2019] [Indexed: 12/15/2022] Open
Abstract
Lipoprotein(a) [Lp(a)], aka “Lp little a”, was discovered in the 1960s in the lab of the Norwegian physician Kåre Berg. Since then, we have greatly improved our knowledge of lipids and cardiovascular disease (CVD). Lp(a) is an enigmatic class of lipoprotein that is exclusively formed in the liver and comprises two main components, a single copy of apolipoprotein (apo) B-100 (apo-B100) tethered to a single copy of a protein denoted as apolipoprotein(a) apo(a). Plasma levels of Lp(a) increase soon after birth to a steady concentration within a few months of life. In adults, Lp(a) levels range widely from <2 to 2500 mg/L. Evidence that elevated Lp(a) levels >300 mg/L contribute to CVD is significant. The improvement of isoform-independent assays, together with the insight from epidemiologic studies, meta-analyses, genome-wide association studies, and Mendelian randomization studies, has established Lp(a) as the single most common independent genetically inherited causal risk factor for CVD. This breakthrough elevated Lp(a) from a biomarker of atherosclerotic risk to a target of therapy. With the emergence of promising second-generation antisense therapy, we hope that we can answer the question of whether Lp(a) is ready for prime-time clinic use. In this review, we present an update on the metabolism, pathophysiology, and current/future medical interventions for high levels of Lp(a).
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Paré G, Çaku A, McQueen M, Anand SS, Enas E, Clarke R, Boffa MB, Koschinsky M, Wang X, Yusuf S. Lipoprotein(a) Levels and the Risk of Myocardial Infarction Among 7 Ethnic Groups. Circulation 2019; 139:1472-1482. [PMID: 30667276 DOI: 10.1161/circulationaha.118.034311] [Citation(s) in RCA: 162] [Impact Index Per Article: 32.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Lipoprotein(a) [Lp(a)] levels predict the risk of myocardial infarction (MI) in populations of European ancestry; however, few data are available for other ethnic groups. Furthermore, differences in isoform size distribution and the associated Lp(a) concentrations have not fully been characterized between ethnic groups. METHODS We studied 6086 cases of first MI and 6857 controls from the INTERHEART study that were stratified by ethnicity and adjusted for age and sex. A total of 775 Africans, 4443 Chinese, 1352 Arabs, 1856 Europeans, 1469 Latin Americans, 1829 South Asians, and 1221 Southeast Asians were included in the study. Lp(a) concentration was measured in each participant using an assay that was insensitive to isoform size, with isoform size being assessed by Western blot in a subset of 4219 participants. RESULTS Variations in Lp(a) concentrations and isoform size distributions were observed between populations, with Africans having the highest Lp(a) concentration (median=27.2 mg/dL) and smallest isoform size (median=24 kringle IV repeats). Chinese samples had the lowest concentration (median=7.8 mg/dL) and largest isoform sizes (median=28). Overall, high Lp(a) concentrations (>50 mg/dL) were associated with an increased risk of MI (odds ratio, 1.48; 95% CI, 1.32-1.67; P<0.001). The association was independent of established MI risk factors, including diabetes mellitus, smoking, high blood pressure, and apolipoprotein B and A ratio. An inverse association was observed between isoform size and Lp(a) concentration, which was consistent across ethnic groups. Larger isoforms tended to be associated with a lower risk of MI, but this relationship was not present after adjustment for concentration. Consistent with variations in Lp(a) concentration across populations, the population-attributable risk of high Lp(a) for MI varied from 0% in Africans to 9.5% in South Asians. CONCLUSIONS Lp(a) concentration and isoform size varied markedly between ethnic groups. Higher Lp(a) concentrations were associated with an increased risk of MI and carried an especially high population burden in South Asians and Latin Americans. Isoform size was inversely associated with Lp(a) concentration, but did not significantly contribute to risk.
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Affiliation(s)
- Guillaume Paré
- Population Health Research Institute, Hamilton, Canada (G.P., M.M., S.S.A., S.Y.).,Genetic & Molecular Epidemiology Laboratory, Department of Pathology and Molecular Medicine (G.P.), McMaster University, Hamilton, Canada
| | - Artuela Çaku
- Department of Biochemistry, University of Sherbrooke, Canada (A.C.)
| | - Matthew McQueen
- Population Health Research Institute, Hamilton, Canada (G.P., M.M., S.S.A., S.Y.).,Department of Pathology and Molecular Medicine (M.M.), McMaster University, Hamilton, Canada.,Clinical Research Laboratory and Biobank, Hamilton Health Sciences, Canada (M.M.)
| | - Sonia S Anand
- Population Health Research Institute, Hamilton, Canada (G.P., M.M., S.S.A., S.Y.).,Department of Medicine (S.S.A.), McMaster University, Hamilton, Canada
| | - Enas Enas
- Coronary Artery Disease Among Asian Indians Research Foundation, Advanced Heart and Lipid Clinic Ltd, Downers Grove, IL (E.E.)
| | - Robert Clarke
- Nuffield Department of Population Health, University of Oxford, UK (R.C.)
| | - Michael B Boffa
- Department of Biochemistry (M.B.B.), Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Marlys Koschinsky
- Department of Physiology and Pharmacology (M.K.), Robarts Research Institute, Schulich School of Medicine and Dentistry, Western University, London, Canada
| | - Xingyu Wang
- Beijing Hypertension League Institute, China (X.W.)
| | - Salim Yusuf
- Population Health Research Institute, Hamilton, Canada (G.P., M.M., S.S.A., S.Y.)
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Boffa MB, Marar TT, Yeang C, Viney NJ, Xia S, Witztum JL, Koschinsky ML, Tsimikas S. Potent reduction of plasma lipoprotein (a) with an antisense oligonucleotide in human subjects does not affect ex vivo fibrinolysis. J Lipid Res 2019; 60:2082-2089. [PMID: 31551368 DOI: 10.1194/jlr.p094763] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2019] [Revised: 08/29/2019] [Indexed: 12/17/2022] Open
Abstract
It is postulated that lipoprotein (a) [Lp(a)] inhibits fibrinolysis, but this hypothesis has not been tested in humans due to the lack of specific Lp(a) lowering agents. Patients with elevated Lp(a) were randomized to antisense oligonucleotide [IONIS-APO(a)Rx] directed to apo(a) (n = 7) or placebo (n = 10). Ex vivo plasma lysis times and antigen concentrations of plasminogen, factor XI, plasminogen activator inhibitor 1, thrombin activatable fibrinolysis inhibitor, and fibrinogen at baseline, day 85/92/99 (peak drug effect), and day 190 (3 months off drug) were measured. The mean ± SD baseline Lp(a) levels were 477.3 ± 55.9 nmol/l in IONIS-APO(a)Rx and 362.1 ± 89.9 nmol/l in placebo. The mean± SD percentage change in Lp(a) for IONIS-APO(a)Rx was -69.3 ± 12.2% versus -5.4 ± 6.9% placebo (P < 0.0010) at day 85/92/99 and -15.6 ± 8.9% versus 3.2 ± 12.2% (P = 0.003) at day 190. Clot lysis times and coagulation/fibrinolysis-related biomarkers showed no significant differences between IONIS-APO(a)Rx and placebo at all time points. Clot lysis times were not affected by exogenously added Lp(a) at concentrations up to 200 nmol/l to plasma with very low (12.5 nmol/l) Lp(a) levels, whereas recombinant apo(a) had a potent antifibrinolytic effect. In conclusion, potent reductions of Lp(a) in patients with highly elevated Lp(a) levels do not affect ex vivo measures of fibrinolysis; the relevance of any putative antifibrinolytic effects of Lp(a) in vivo needs further study.
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Affiliation(s)
- Michael B Boffa
- Department of Biochemistry Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Tanya T Marar
- Department of Biochemistry Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Calvin Yeang
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA
| | | | | | - Joseph L Witztum
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA
| | - Marlys L Koschinsky
- Robarts Research Institute, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, ON, Canada
| | - Sotirios Tsimikas
- Division of Endocrinology and Metabolism, University of California San Diego, La Jolla, CA .,Ionis Pharmaceuticals, Carlsbad, CA
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9
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Skuza AA, Polak M, Undas A. Elevated lipoprotein(a) as a new risk factor of cerebral venous sinus thrombosis: association with fibrin clot properties. J Thromb Thrombolysis 2019; 47:8-15. [PMID: 30511257 PMCID: PMC6336752 DOI: 10.1007/s11239-018-1769-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Elevated lipoprotein(a) [Lp(a)] has been reported to be associated with prothrombotic clot phenotype. We hypothesized that increased Lp(a) contributes to cerebral venous sinus thrombosis (CVST) and its recurrence in relation to clot features. In 80 consecutive patients (aged 39.36 ± 10.18 years, 61 women) following the first CVST after anticoagulation withdrawal, we assessed Lp(a) levels and plasma clot properties. Recurrence of CVST was recorded during follow-up (median 53, interquartile range 40-59 months). Lp(a) levels were inversely associated with clot permeability (Ks, r = - 0.58, P < 0.001) and the rate of D-dimer release from clots in the presence of tissue plasminogen activator (r = - 0.27, P = 0.017) along with increased maximum absorbance of fibrin gels (r = 0.42, P < 0.001) and maximum D-dimer levels achieved during lysis (D-Dmax, r = 0.29, P = 0.01). Recurrence of CVST was observed in 12 patients (15%) after median follow-up of 26 months. Lp(a) concentrations were higher in patients with recurrence of CVST compared to the remainder (14.15 [8.85-25.25] vs. 28.3 [18.9-35.6] mg/dL; P = 0.001). The risk of recurrent CVST was fourfold higher among 17 (21.25%) patients with Lp(a) > 30 mg/dL compared to the remainder (adjusted hazard ratio, 3.9; 95% confidence interval [CI] 1.23-12.4). Recurrence of CVST was associated with 14% lower Ks (P = 0.001) and 10% higher D-Dmax (P = 0.008), with no differences in other clot features. Multiple logistic regression model showed that CVST recurrence was independently associated with Lp(a) (odds ratio 1.09, 95% CI 1.02-1.16). Increased Lp(a) characterizes subjects at elevated risk of recurrent CVST after anticoagulation withdrawal, which could be partly explained by formation of denser fibrin clots.
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Affiliation(s)
- Anna Aleksandra Skuza
- Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka St, 31-202, Cracow, Poland
| | - Maciej Polak
- Department of Epidemiology and Population Studies, Jagiellonian University Medical College, Krakow, Poland
| | - Anetta Undas
- Institute of Cardiology, Jagiellonian University Medical College, 80 Pradnicka St, 31-202, Cracow, Poland. .,John Paul II Hospital, Krakow, Poland.
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Apolipoprotein(a) inhibits the conversion of Glu-plasminogen to Lys-plasminogen on the surface of vascular endothelial and smooth muscle cells. Thromb Res 2018; 169:1-7. [DOI: 10.1016/j.thromres.2018.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2017] [Revised: 05/31/2018] [Accepted: 07/03/2018] [Indexed: 11/24/2022]
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11
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Scipione CA, Koschinsky ML, Boffa MB. Lipoprotein(a) in clinical practice: New perspectives from basic and translational science. Crit Rev Clin Lab Sci 2017; 55:33-54. [PMID: 29262744 DOI: 10.1080/10408363.2017.1415866] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Elevated plasma concentrations of lipoprotein(a) (Lp(a)) are a causal risk factor for coronary heart disease (CHD) and calcific aortic valve stenosis (CAVS). Genetic, epidemiological and in vitro data provide strong evidence for a pathogenic role for Lp(a) in the progression of atherothrombotic disease. Despite these advancements and a race to develop new Lp(a) lowering therapies, there are still many unanswered and emerging questions about the metabolism and pathophysiology of Lp(a). New studies have drawn attention to Lp(a) as a contributor to novel pathogenic processes, yet the mechanisms underlying the contribution of Lp(a) to CVD remain enigmatic. New therapeutics show promise in lowering plasma Lp(a) levels, although the complete mechanisms of Lp(a) lowering are not fully understood. Specific agents targeted to apolipoprotein(a) (apo(a)), namely antisense oligonucleotide therapy, demonstrate potential to decrease Lp(a) to levels below the 30-50 mg/dL (75-150 nmol/L) CVD risk threshold. This therapeutic approach should aid in assessing the benefit of lowering Lp(a) in a clinical setting.
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Affiliation(s)
- Corey A Scipione
- a Department of Advanced Diagnostics , Toronto General Hospital Research Institute, UHN , Toronto , Canada
| | - Marlys L Koschinsky
- b Robarts Research Institute , Western University , London , Canada.,c Department of Physiology & Pharmacology , Schulich School of Medicine & Dentistry, Western University , London , Canada
| | - Michael B Boffa
- d Department of Biochemistry , Western University , London , Canada
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Scipione CA, McAiney JT, Simard DJ, Bazzi ZA, Gemin M, Romagnuolo R, Macrae FL, Ariëns RA, Hegele RA, Auld J, Gauld JW, Boffa MB, Koschinsky ML. Characterization of the I4399M variant of apolipoprotein(a): implications for altered prothrombotic properties of lipoprotein(a). J Thromb Haemost 2017; 15:1834-1844. [PMID: 28632940 DOI: 10.1111/jth.13759] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Indexed: 11/30/2022]
Abstract
Essentials Elevated lipoproteinp(a) is an independent and causal risk factor for atherothrombotic diseases. rs3798220 (Ile/Met substitution in apo(a) protease-like domain) is associated with disease risk. Recombinant I4399M apo(a) altered clot structure to accelerate coagulation/delay fibrinolysis. Evidence was found for increased solvent exposure and oxidation of Met residue. SUMMARY Background Lipoprotein(a) (Lp[a]) is a causal risk factor for a variety of cardiovascular diseases. Apolipoprotein(a) (apo[a]), the distinguishing component of Lp(a), is homologous with plasminogen, suggesting that Lp(a) can interfere with the normal fibrinolytic functions of plasminogen. This has implications for the persistence of fibrin clots in the vasculature and hence for atherothrombotic diseases. A single-nucleotide polymorphism (SNP) (rs3798220) in the gene encoding apo(a) has been reported that results in an Ile→Met substitution in the protease-like domain (I4399M variant). In population studies, the I4399M variant has been correlated with elevated plasma Lp(a) levels and higher coronary heart disease risk, and carriers of the SNP had increased cardiovascular benefit from aspirin therapy. In vitro studies suggested an antifibrinolytic role for Lp(a) containing this variant. Objectives We performed a series of experiments to assess the effect of the Ile→Met substitution on fibrin clot formation and lysis, and on the architecture of the clots. Results We found that the Met variant decreased coagulation time and increased fibrin clot lysis time as compared with wild-type apo(a). Furthermore, we observed that the presence of the Met variant significantly increased fibrin fiber width in plasma clots formed ex vivo, while having no effect on fiber density. Mass spectrometry analysis of a recombinant apo(a) species containing the Met variant revealed sulfoxide modification of the Met residue. Conclusions Our data suggest that the I4399M variant differs structurally from wild-type apo(a), which may underlie key differences related to its effects on fibrin clot architecture and fibrinolysis.
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Affiliation(s)
- C A Scipione
- Robarts Research Institute, London, Ontario, Canada
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - J T McAiney
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - D J Simard
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - Z A Bazzi
- Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - M Gemin
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - R Romagnuolo
- University Health Network, Toronto, Ontario, Canada
| | - F L Macrae
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R A Ariëns
- Thrombosis and Tissue Repair Group, Division of Cardiovascular and Diabetes Research, Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, UK
| | - R A Hegele
- Robarts Research Institute, London, Ontario, Canada
- Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
- Department of Medicine, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - J Auld
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - J W Gauld
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, Ontario, Canada
| | - M B Boffa
- Department of Biochemistry, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
| | - M L Koschinsky
- Robarts Research Institute, London, Ontario, Canada
- Department of Physiology & Pharmacology, Schulich School of Medicine & Dentistry, The University of Western Ontario, London, Ontario, Canada
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Puri R, Ballantyne CM, Hoogeveen RC, Shao M, Barter P, Libby P, Chapman MJ, Erbel R, Arsenault BJ, Raichlen JS, Nissen SE, Nicholls SJ. Lipoprotein(a) and coronary atheroma progression rates during long-term high-intensity statin therapy: Insights from SATURN. Atherosclerosis 2017. [PMID: 28641153 DOI: 10.1016/j.atherosclerosis.2017.06.026] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND & AIMS Lipoprotein(a) [Lp(a)] is a low-density lipoprotein (LDL)-like particle that associates with major adverse cardiovascular events (MACE). We examined relationships between Lp(a) measurements and changes in coronary atheroma volume following long-term maximally-intensive statin therapy in coronary artery disease patients. METHODS Study of coronary atheroma by intravascular ultrasound: Effect of Rosuvastatin Versus Atorvastatin (SATURN) used serial intravascular ultrasound measures of coronary atheroma volume in patients treated with rosuvastatin 40 mg or atorvastatin 80 mg for 24 months. Baseline and follow-up Lp(a) levels were measured in 915 of the 1039 SATURN participants, and were correlated with changes in percent atheroma volume (ΔPAV). RESULTS Mean age was 57.7 ± 8.6 years, 74% were men, 96% were Caucasian, with statin use prior to study enrolment occurring in 59.3% of participants. Baseline [median (IQR)] LDL-cholesterol (LDL-C) and measured Lp(a) levels (mg/dL) were 114 (99, 137) and 17.4 (7.6, 52.9) respectively; follow-up measures were 60 (47, 77), and 16.5 (6.7, 57.7) (change from baseline: p < 0.001, p = 0.31 respectively). At baseline, there were 676 patients with Lp(a) levels <50 mg/dL [median Lp(a) of 10.9 mg/dL], and 239 patients with Lp(a) levels ≥ 50 mg/dL [median Lp(a) of 83.2 mg/dL]. Quartiles of baseline and follow-up Lp(a) did not associate with ΔPAV. Irrespective of the achieved LDL-C (<vs. ≥70 mg/dL), neither baseline nor on-treatment (<vs. ≥median) Lp(a) levels significantly associated with ΔPAV. No significant differences were observed in ΔPAV in Lp(a) risers versus non-risers, nor in those patients with baseline or on-treatment Lp(a) levels <vs. > 50 mg/dL. CONCLUSIONS In coronary artery disease patients prescribed long-term maximally intensive statin therapy with low on-treatment LDL-C levels, measured Lp(a) levels (predominantly below the 50 mg/dL threshold) do not associate with coronary atheroma progression. Alternative biomarkers may thus associate with residual cardiovascular risk in such patients.
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Affiliation(s)
- Rishi Puri
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, United States; Quebec Heart & Lung Institute, Quebec City, Canada; Department of Medicine, University of Adelaide, Adelaide, Australia
| | - Christie M Ballantyne
- Section of Cardiovascular Research, Baylor College of Medicine, The Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
| | - Ron C Hoogeveen
- Section of Cardiovascular Research, Baylor College of Medicine, The Methodist DeBakey Heart and Vascular Center, Houston, TX, United States
| | - Mingyuan Shao
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, United States
| | - Philip Barter
- Centre for Vascular Research, University of New South Wales, Sydney, Australia
| | - Peter Libby
- Cardiovascular Division, Brigham and Women's Hospital, Boston, MA, United States
| | - M John Chapman
- INSERM Dyslipidaemia and Atherosclerosis Research Unit, Pitié-Salpetriere University Hospital, Paris, France
| | | | | | | | - Steven E Nissen
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, United States
| | - Stephen J Nicholls
- Cleveland Clinic Coordinating Center for Clinical Research (C5R), Cleveland Clinic, Cleveland, OH, United States; Department of Medicine, University of Adelaide, Adelaide, Australia; South Australian Health and Medical Research Institute, Adelaide, Australia.
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Xie H, Chen L, Liu H, Cui Y, Zhang Z, Cui L. Long-Term Prognostic Value of Lipoprotein(a) in Symptomatic Patients With Nonobstructive Coronary Artery Disease. Am J Cardiol 2017; 119:945-950. [PMID: 28139221 DOI: 10.1016/j.amjcard.2016.11.053] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 11/29/2016] [Accepted: 11/29/2016] [Indexed: 11/17/2022]
Abstract
Our study aimed to evaluate the association of lipoprotein(a) [Lp(a)] and prognosis in patients with nonobstructive coronary artery disease (CAD). A total of 4,254 symptomatic patients with suspected CAD referred for coronary angiography were analyzed and 451 patients (250 women, average age 58 ± 9 years) with nonobstructive CAD (defined as no angiographic stenosis ≥50% in any major epicardial artery) were finally included in our cohort. Subjects were categorized into tertile groups according to Lp(a) levels on admission. The primary end point was major adverse cardiovascular events (MACEs), defined as cardiac death and incident acute coronary syndrome. Over a mean follow-up of 32 ± 22 months, 37 (8%) MACE (15 cases of cardiac death and 22 cases of acute coronary syndrome) occurred. Kaplan-Meier analysis revealed that elevated Lp(a) level was associated with worse prognosis (p = 0.001). After Cox multivariate adjustment for other clinical confounders, an elevated Lp(a) level remained an independent predictor of MACE either as a continuous variable (hazard ratio 1.031, 95% confidence interval 1.019 to 1.043, p <0.001) or as a categorical variable (hazard ratio 3.155, 95% confidence interval 1.599 to 6.229, p = 0.001). Furthermore, addition of Lp(a) to established coronary risk factors significantly improved the predictive value of reference models for MACE. In conclusion, an elevated Lp(a) level is independently associated with worse prognosis and may provide useful risk stratification in symptomatic patients with nonobstructive CAD.
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Affiliation(s)
- Hao Xie
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Liming Chen
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
| | - Hang Liu
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Yuqi Cui
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Zhun Zhang
- Department of Breast and Thyroid Surgery, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China
| | - Lianqun Cui
- Department of Cardiology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.
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Bucci M, Tana C, Giamberardino MA, Cipollone F. Lp(a) and cardiovascular risk: Investigating the hidden side of the moon. Nutr Metab Cardiovasc Dis 2016; 26:980-986. [PMID: 27514608 DOI: 10.1016/j.numecd.2016.07.004] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Revised: 06/21/2016] [Accepted: 07/06/2016] [Indexed: 12/21/2022]
Abstract
AIMS This article reports current evidence on the association between Lp(a) and cardiovascular (CV) disease and on pathophysiological mechanisms. The available information on therapy for reduction of lipoprotein(a) is also discussed. DATA SYNTHESIS Although some evidence is conflicting, Lp(a) seems to increase CV risk through stimulation of platelet aggregation, inhibition of tissue factor pathway inhibitor, alteration of fibrin clot structure and promotion of endothelial dysfunction and phospholipid oxidation. Lp(a) 3.5-fold higher than normal increases the risk of coronary heart disease and general CV events, particularly in those with LDL cholesterol ≥ 130 mg/dl. High Lp(a) values represent also an independent risk factor for ischemic stroke (more relevant in young stroke patients), peripheral artery disease (PAD) and aortic and mitral stenosis. Furthermore, high Lp(a) levels seem to be associated with increased risk of cardiovascular events in patients with chronic kidney disease, particularly in those undergoing percutaneous coronary intervention. CONCLUSIONS Lipoprotein (a) (Lp[a]) seems to significantly influence the risk of cardiovascular events. The effects of statins and fibrates on Lp(a) are limited and extremely variable. Nicotinic acid was shown effective in reducing Lp(a) but, due to its side effects and serious adverse events during clinical trials, it is no longer considered a possible option for treatment. To date, the treatment of choice for high levels of Lp(a) in high CV risk patients is represented by LDL-Apheresis. Thanks to innovative technologies, new selectively inhibiting LPA drugs are being developed and tested.
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Affiliation(s)
- M Bucci
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital - ASL Chieti, Italy; Ce.S.I.-Met, "G. D'Annunzio" University of Chieti, Italy
| | - C Tana
- Internal Medicine Unit, Guastalla Hospital, AUSL Reggio Emilia, Italy
| | - M A Giamberardino
- Ce.S.I.-Met, "G. D'Annunzio" University of Chieti, Italy; Geriatrics Clinic, Department of Medicine and Science of Aging, "G. D'Annunzio" University of Chieti, Italy
| | - F Cipollone
- Regional Center for the Study of Atherosclerosis, Hypertension and Dyslipidemia, "SS Annunziata" Hospital - ASL Chieti, Italy; Ce.S.I.-Met, "G. D'Annunzio" University of Chieti, Italy; Geriatrics Clinic, Department of Medicine and Science of Aging, "G. D'Annunzio" University of Chieti, Italy.
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Park SH, Rha SW, Choi BG, Park JY, Jeon U, Seo HS, Kim EJ, Na JO, Choi CU, Kim JW, Lim HE, Park CG, Oh DJ. Impact of high lipoprotein(a) levels on in-stent restenosis and long-term clinical outcomes of angina pectoris patients undergoing percutaneous coronary intervention with drug-eluting stents in Asian population. Clin Exp Pharmacol Physiol 2016; 42:588-95. [PMID: 25865336 DOI: 10.1111/1440-1681.12396] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2014] [Revised: 02/22/2015] [Accepted: 03/28/2015] [Indexed: 11/29/2022]
Abstract
Lipoprotein(a) (Lp(a)) is known to be associated with cardiovascular complications and atherothrombotic properties in general populations. However, it has not been examined whether Lp(a) levels are able to predict adverse cardiovascular outcomes in patients undergoing percutaneous coronary intervention (PCI) with drug-eluting stents (DES). A total of 595 consecutive patients with angina pectoris who underwent elective PCI with DES were enrolled from 2004 to 2010. The patients were divided into two groups according to the levels of Lp(a): Lp(a) < 50 mg/dL (n = 485 patients), and Lp(a) ≥ 50 mg/dL (n = 111 patients). The 6-9-month angiographic outcomes and 3-year cumulative major clinical outcomes were compared between the two groups. Binary restenosis occurred in 26 of 133 lesions (19.8%) in the high Lp(a) group and 43 of 550 lesions (7.9%) in the low Lp(a) group (P = 0.001). In multivariate analysis, the reference vessel diameter, low density lipoprotein cholesterol, total lesion length, and Lp(a) ≥ 50 mg/dL were predictors of binary restenosis. In the Cox proportional hazards regression analysis, Lp(a) > 50 mg/dL was significantly associated with the 3-year adverse clinical outcomes including any myocardial infarction, revascularization (target lesion revascularization (TLR) and target vessel revascularization (TVR)), TLR-major adverse cardiac events (MACEs), TVR-MACE, and All-MACEs. In our study, high Lp(a) level ≥ 50 mg/dL in angina pectoris patients undergoing elective PCI with DES was significantly associated with binary restenosis and 3-year adverse clinical outcomes in an Asian population.
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Affiliation(s)
- Sang-Ho Park
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Korea
| | - Seung-Woon Rha
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Byoung-Geol Choi
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Ji-Young Park
- Division of Cardiology, Department of Internal Medicine, Eulji Medical University, Seoul, Korea
| | - Ung Jeon
- Division of Cardiology, Department of Internal Medicine, Soonchunhyang University, Cheonan Hospital, Cheonan, Korea
| | - Hong-Seog Seo
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Eung-Ju Kim
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Jin-Oh Na
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Cheol-Ung Choi
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Jin-Won Kim
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Hong-Euy Lim
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Chang-Gyu Park
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
| | - Dong-Joo Oh
- Cardiovascular Center, Korea University, Guro Hospital, Seoul, Korea
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17
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Yeang C, Cotter B, Tsimikas S. Experimental Animal Models Evaluating the Causal Role of Lipoprotein(a) in Atherosclerosis and Aortic Stenosis. Cardiovasc Drugs Ther 2016; 30:75-85. [DOI: 10.1007/s10557-015-6634-1] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
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18
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Lipoprotein (a) is related to coronary atherosclerotic burden and a vulnerable plaque phenotype in angiographically obstructive coronary artery disease. Atherosclerosis 2016; 246:214-20. [PMID: 26803430 DOI: 10.1016/j.atherosclerosis.2016.01.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/10/2016] [Accepted: 01/11/2016] [Indexed: 11/23/2022]
Abstract
BACKGROUND Lipoprotein Lp(a) has been shown to be an independent risk factor for coronary artery disease (CAD). However, its association with CAD burden in patients with ACS is largely unknown, as well as the association of Lp(a) with lipid rich plaques prone to rupture. AIM We aim at assessing CAD burden by coronary angiography and plaque features including thin cap fibroatheroma (TCFA) by optical coherence tomography (OCT) in consecutive patients presenting with acute coronary syndrome (ACS) and obstructive CAD along with serum Lp(a) levels. METHODS This study comprises an angiographic and an OCT cohort. A total of 500 ACS patients (370 men, average age 66 ± 11) were enrolled for the angiographic cohort and 51 ACS patients (29 males, average age 65 ± 11) were enrolled for the OCT cohort. Angiographic CAD severity was assessed by Sullivan score and by Bogaty score including stenosis score and extent index. OCT plaque features were evaluated at the site of the minimal lumen area and along the culprit segment. RESULTS In the angiographic cohort, at multivariate analysis, Lp(a) was a weak independent predictor of Sullivan score (p < 0.0001), stenosis score (p < 0.0001) and extent index (p < 0.0001). In the OCT cohort, patients with higher Lp(a) levels (≥ 30 md/dl) compared to patients with lower Lp(a) levels (<30 md/dl) exhibited a higher prevalence of lipidic plaque at the site of the culprit stenosis (67% vs. 27%; P = 0.02), a wider lipid arc (135 ± 114 vs 59 ± 111; P = 0.03) and a higher prevalence of TCFA (38% vs. 10%; P = 0.04). CONCLUSIONS Among patients with ACS, raised Lp(a) levels are associated with an increased atherosclerotic burden and it identifies a subset of patients with features of high risk coronary atherosclerosis.
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Boffa MB, Koschinsky ML. Lipoprotein (a): truly a direct prothrombotic factor in cardiovascular disease? J Lipid Res 2015; 57:745-57. [PMID: 26647358 DOI: 10.1194/jlr.r060582] [Citation(s) in RCA: 162] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2015] [Indexed: 01/13/2023] Open
Abstract
Elevated plasma concentrations of lipoprotein (a) [Lp(a)] have been determined to be a causal risk factor for coronary heart disease, and may similarly play a role in other atherothrombotic disorders. Lp(a) consists of a lipoprotein moiety indistinguishable from LDL, as well as the plasminogen-related glycoprotein, apo(a). Therefore, the pathogenic role for Lp(a) has traditionally been considered to reflect a dual function of its similarity to LDL, causing atherosclerosis, and its similarity to plasminogen, causing thrombosis through inhibition of fibrinolysis. This postulate remains highly speculative, however, because it has been difficult to separate the prothrombotic/antifibrinolytic functions of Lp(a) from its proatherosclerotic functions. This review surveys the current landscape surrounding these issues: the biochemical basis for procoagulant and antifibrinolytic effects of Lp(a) is summarized and the evidence addressing the role of Lp(a) in both arterial and venous thrombosis is discussed. While elevated Lp(a) appears to be primarily predisposing to thrombotic events in the arterial tree, the fact that most of these are precipitated by underlying atherosclerosis continues to confound our understanding of the true pathogenic roles of Lp(a) and, therefore, the most appropriate therapeutic target through which to mitigate the harmful effects of this lipoprotein.
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Affiliation(s)
- Michael B Boffa
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada
| | - Marlys L Koschinsky
- Department of Chemistry and Biochemistry, University of Windsor, Windsor, ON, Canada Robarts Research Institute, Western University, London, ON, Canada
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Chan DC, Pang J, Hooper AJ, Burnett JR, Bell DA, Bates TR, van Bockxmeer FM, Watts GF. Elevated lipoprotein(a), hypertension and renal insufficiency as predictors of coronary artery disease in patients with genetically confirmed heterozygous familial hypercholesterolemia. Int J Cardiol 2015; 201:633-8. [DOI: 10.1016/j.ijcard.2015.08.146] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 07/22/2015] [Accepted: 08/20/2015] [Indexed: 12/16/2022]
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Criado PR, Alavi A, Valente NYS, Sotto MN. Amantadine-Induced Livedo Racemosa. INT J LOW EXTR WOUND 2015; 15:78-81. [DOI: 10.1177/1534734615603566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Although livedo reticularis is a known adverse effect of amantadine, only limited studies have addressed this association. Livedo racemosa in contrast to livedo reticularis is characterized by a striking violaceous netlike pattern of the skin similar to livedo reticularis with a different histopathology and morphology (irregular, broken circular segments). In this case report, we present 2 cases of livedo racemosa and edema of lower extremities following amantadine treatment. The cutaneous biopsies in both cases showed intraluminal thrombi in subcutaneous blood vessels without evidence of vasculitis, which is consistent with livedo racemosa.
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Govindan KPS, Basha S, Ramesh V, Kumar CN, Swathi S. A comparative study on serum lipoprotein (a) and lipid profile between rheumatoid arthritis patients and normal subjects. J Pharm Bioallied Sci 2015; 7:S22-5. [PMID: 26015716 PMCID: PMC4439676 DOI: 10.4103/0975-7406.155767] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2014] [Revised: 10/31/2014] [Accepted: 11/09/2014] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Rheumatoid arthritis is a chronic and systemic inflammatory disorder, in which Lipoprotein (a) [Lp (a)] increases plaque formation and thus promotes atherosclerosis. Coronary artery disease is one of the co-morbidity in rheumatoid arthritis patients. AIM The aim of this study is to evaluate Lp (a) as a cardiovascular risk factor in patients with rheumatoid arthritis. This was a comparative study in which Lp (a) and lipid profile were compared in rheumatoid arthritis patients and controls. MATERIALS AND METHODS The study included 30 sero-positive rheumatoid arthritis patients and 30 normal healthy subjects with an age and sex matched group of 25-80 years. Statistical analysis was performed using SPSS version 17. RESULTS Serum Lp (a) concentration was significantly increased (P < 0.001) in rheumatoid arthritis patients compared with controls. Serum high-density lipoprotein-cholesterol was significantly lowered (P < 0.05) in patients as compared to controls. There was no significant difference in serum total cholesterol, triglycerides, and very low density lipoprotein-cholesterol between patients and controls. CONCLUSION The findings indicate that the patients with rheumatoid arthritis are at high risk of developing cardiovascular disease in future due to the increased level of Lp (a). In addition to conventional lipid profile, estimation of Lp (a) can prove to be a valuable tool in risk assessment of population in general and management of disease in particular.
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Affiliation(s)
- K P Shiva Govindan
- Department of Biochemistry, Melmaruvathur Adhiparasakthi Institute of Medical Science and Research, Melmaruvathur, Tamil Nadu, India
| | - Saleem Basha
- Department of Biochemistry, Melmaruvathur Adhiparasakthi Institute of Medical Science and Research, Melmaruvathur, Tamil Nadu, India
| | - V Ramesh
- Department of Biochemistry, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, Affiliated to Bharath University, Tamil Nadu, India
| | - C Naveen Kumar
- Department of Biochemistry, Sri Lakshmi Narayana Institute of Medical Sciences, Puducherry, Affiliated to Bharath University, Tamil Nadu, India
| | - S Swathi
- Department of Microbiology, Madha Dental College, Chennai, Tamil Nadu, India
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Tadin-Strapps M, Robinson M, Le Voci L, Andrews L, Yendluri S, Williams S, Bartz S, Johns DG. Development of Lipoprotein(a) siRNAs for Mechanism of Action Studies in Non-Human Primate Models of Atherosclerosis. J Cardiovasc Transl Res 2015; 8:44-53. [DOI: 10.1007/s12265-014-9605-1] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2014] [Accepted: 12/29/2014] [Indexed: 01/13/2023]
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Månsson M, Kalies I, Bergström G, Schmidt C, Legnehed A, Hultén LM, Amrot-Fors L, Gustafsson D, Knecht W. Lp(a) is not associated with diabetes but affects fibrinolysis and clot structure ex vivo. Sci Rep 2014; 4:5318. [PMID: 24937703 PMCID: PMC4060502 DOI: 10.1038/srep05318] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2014] [Accepted: 05/21/2014] [Indexed: 01/17/2023] Open
Abstract
Lipoprotein (a) [Lp(a)] is a low density lipoprotein (LDL) with one apolipoprotein (a) molecule bound to the apolipoprotein B-100 of LDL. Lp(a) is an independent risk factor for cardiovascular disease (CVD). However, the relationship of Lp(a) to diabetes and metabolic syndrome, both known for increased CVD risk, is controversial. In a population based study on type two diabetes mellitus (T2DM) development in women, Lp(a) plasma levels showed the well known skewed distribution without any relation to diabetes or impaired glucose tolerance. A modified clot lysis assay on a subset of 274 subjects showed significantly increased clot lysis times in T2DM subjects, despite inhibition of PAI-1 and TAFI. Lp(a) plasma levels significantly increased the maximal peak height of the clot lysis curve, indicating a change in clot structure. In this study Lp(a) is not related to the development of T2DM but may affect clot structure ex vivo without a prolongation of the clot lysis time.
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Affiliation(s)
| | - Inge Kalies
- AstraZeneca R&D Mölndal, 431 83 Mölndal, Sweden
| | - Göran Bergström
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, University of Gothenburg, S-41345 Göteborg, Sweden
| | - Caroline Schmidt
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, University of Gothenburg, S-41345 Göteborg, Sweden
| | | | - Lillemor Mattsson Hultén
- Wallenberg Laboratory for Cardiovascular Research, Sahlgrenska Academy, University of Gothenburg, S-41345 Göteborg, Sweden
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Hernández-Castellano LE, Almeida AM, Ventosa M, Coelho AV, Castro N, Argüello A. The effect of colostrum intake on blood plasma proteome profile in newborn lambs: low abundance proteins. BMC Vet Res 2014; 10:85. [PMID: 24708841 PMCID: PMC4108057 DOI: 10.1186/1746-6148-10-85] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 03/26/2014] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Colostrum intake by newborn lambs plays a fundamental role in the perinatal period, ensuring lamb survival. In this study, blood plasma samples from two groups of newborn lambs (Colostrum group and Delayed Colostrum group) at 2 and 14 h after birth were treated to reduce the content of high abundance proteins and analyzed using Two-Dimensional Differential in Gel Electrophoresis and MALDI MS/MS for protein identification in order to investigate low abundance proteins with immune function in newborn lambs. RESULTS The results showed that four proteins were increased in the blood plasma of lambs due to colostrum intake. These proteins have not been previously described as increased in blood plasma of newborn ruminants by colostrum intake. Moreover, these proteins have been described as having an immune function in other species, some of which were previously identified in colostrum and milk. CONCLUSIONS In conclusion, colostrum intake modified the low abundance proteome profile of blood plasma from newborn lambs, increasing the concentration of apolipoprotein A-IV, plasminogen, serum amyloid A and fibrinogen, demonstrating that colostrum is essential, not only for the provision of immunoglobulins, but also because of increases in several low abundance proteins with immune function.
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Affiliation(s)
| | - André Martinho Almeida
- Instituto de Tecnología Química e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
- Instituto de Investigação Científica Tropical (IICT) & Centro Interdisciplinar de Investigação em Sanidade Animal (CIISA), Lisbon, Portugal
- Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
| | - Miguel Ventosa
- Instituto de Biologia Experimental e Tecnológica, Oeiras, Portugal
| | - Ana Varela Coelho
- Instituto de Tecnología Química e Biologica, Universidade Nova de Lisboa, Oeiras, Portugal
| | - Noemí Castro
- Department of Animal Science, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain
| | - Anastasio Argüello
- Department of Animal Science, Universidad de Las Palmas de Gran Canaria, Arucas, Gran Canaria, Spain
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Romagnuolo R, Marcovina SM, Boffa MB, Koschinsky ML. Inhibition of plasminogen activation by apo(a): role of carboxyl-terminal lysines and identification of inhibitory domains in apo(a). J Lipid Res 2014; 55:625-34. [PMID: 24478033 DOI: 10.1194/jlr.m036566] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Apo(a), the distinguishing protein component of lipoprotein(a) [Lp(a)], exhibits sequence similarity to plasminogen and can inhibit binding of plasminogen to cell surfaces. Plasmin generated on the surface of vascular cells plays a role in cell migration and proliferation, two of the fibroproliferative inflammatory events that underlie atherosclerosis. The ability of apo(a) to inhibit pericellular plasminogen activation on vascular cells was therefore evaluated. Two isoforms of apo(a), 12K and 17K, were found to significantly decrease tissue-type plasminogen activator-mediated plasminogen activation on human umbilical vein endothelial cells (HUVECs) and THP-1 monocytes and macrophages. Lp(a) purified from human plasma decreased plasminogen activation on THP-1 monocytes and HUVECs but not on THP-1 macrophages. Removal of kringle V or the strong lysine binding site in kringle IV10 completely abolished the inhibitory effect of apo(a). Treatment with carboxypeptidase B to assess the roles of carboxyl-terminal lysines in cellular receptors leads in most cases to decreases in plasminogen activation as well as plasminogen and apo(a) binding; however, inhibition of plasminogen activation by apo(a) was unaffected. Our findings directly demonstrate that apo(a) inhibits pericellular plasminogen activation in all three cell types, although binding of apo(a) to cell-surface receptors containing carboxyl-terminal lysines does not appear to play a major role in the inhibition mechanism.
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Affiliation(s)
- Rocco Romagnuolo
- Department of Chemistry & Biochemistry, University of Windsor, Windsor, ON, Canada; and
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28
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Leibundgut G, Scipione C, Yin H, Schneider M, Boffa MB, Green S, Yang X, Dennis E, Witztum JL, Koschinsky ML, Tsimikas S. Determinants of binding of oxidized phospholipids on apolipoprotein (a) and lipoprotein (a). J Lipid Res 2013; 54:2815-30. [PMID: 23828779 DOI: 10.1194/jlr.m040733] [Citation(s) in RCA: 160] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Oxidized phospholipids (OxPLs) are present on apolipoprotein (a) [apo(a)] and lipoprotein (a) [Lp(a)] but the determinants influencing their binding are not known. The presence of OxPLs on apo(a)/Lp(a) was evaluated in plasma from healthy humans, apes, monkeys, apo(a)/Lp(a) transgenic mice, lysine binding site (LBS) mutant apo(a)/Lp(a) mice with Asp(55/57)→Ala(55/57) substitution of kringle (K)IV10)], and a variety of recombinant apo(a) [r-apo(a)] constructs. Using antibody E06, which binds the phosphocholine (PC) headgroup of OxPLs, Western and ELISA formats revealed that OxPLs were only present in apo(a) with an intact KIV10 LBS. Lipid extracts of purified human Lp(a) contained both E06- and nonE06-detectable OxPLs by tandem liquid chromatography-mass spectrometry (LC-MS/MS). Trypsin digestion of 17K r-apo(a) showed PC-containing OxPLs covalently bound to apo(a) fragments by LC-MS/MS that could be saponified by ammonium hydroxide. Interestingly, PC-containing OxPLs were also present in 17K r-apo(a) with Asp(57)→Ala(57) substitution in KIV10 that lacked E06 immunoreactivity. In conclusion, E06- and nonE06-detectable OxPLs are present in the lipid phase of Lp(a) and covalently bound to apo(a). E06 immunoreactivity, reflecting pro-inflammatory OxPLs accessible to the immune system, is strongly influenced by KIV10 LBS and is unique to human apo(a), which may explain Lp(a)'s pro-atherogenic potential.
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Affiliation(s)
- Gregor Leibundgut
- Departments of Medicine, University of California, San Diego, La Jolla, CA
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29
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Undas A, Cieśla-Dul M, Drążkiewicz T, Sadowski J. Altered fibrin clot properties are associated with residual vein obstruction: Effects of lipoprotein(a) and apolipoprotein(a) isoform. Thromb Res 2012; 130:e184-7. [DOI: 10.1016/j.thromres.2012.06.005] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2012] [Revised: 05/04/2012] [Accepted: 06/04/2012] [Indexed: 10/28/2022]
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30
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Leibundgut G, Arai K, Orsoni A, Yin H, Scipione C, Miller ER, Koschinsky ML, Chapman MJ, Witztum JL, Tsimikas S. Oxidized phospholipids are present on plasminogen, affect fibrinolysis, and increase following acute myocardial infarction. J Am Coll Cardiol 2012; 59:1426-37. [PMID: 22497821 DOI: 10.1016/j.jacc.2011.12.033] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2011] [Revised: 12/16/2011] [Accepted: 12/22/2011] [Indexed: 02/03/2023]
Abstract
OBJECTIVES This study sought to assess whether plasminogen, which is homologous to lipoprotein (a) [Lp(a)], contains proinflammatory oxidized phospholipids (OxPL) and whether this has clinical relevance. BACKGROUND OxPL measured on apolipoprotein B-100 (OxPL/apoB), primarily reflecting OxPL on Lp(a), independently predict cardiovascular disease (CVD) events. METHODS The authors examined plasminogen from commercially available preparations and plasma from chimpanzees; gorillas; bonobos; cynomolgus monkeys; wild-type, apoE(-/-), LDLR(-/-), and Lp(a)-transgenic mice; healthy humans; and patients with familial hypercholesterolemia, stable CVD, and acute myocardial infarction (AMI). Phosphocholine (PC)-containing OxPL (OxPC) present on plasminogen were detected directly with liquid chromatography-mass spectrometry (LC-MS/MS) and immunologically with monoclonal antibody E06. In vitro clot lysis assays were performed to assess the effect of the OxPL on plasminogen on fibrinolysis. RESULTS LC-MS/MS revealed that OxPC fragments were covalently bound to mouse plasminogen. Immunoblot, immunoprecipitation, density gradient ultracentrifugation, and enzyme-linked immunosorbent assay analyses demonstrated that all human and animal plasma samples tested contained OxPL covalently bound to plasminogen. In plasma samples subjected to density gradient fractionation, OxPL were present on plasminogen (OxPL/plasminogen) in non-lipoprotein fractions but on Lp(a) in lipoprotein fractions. Plasma levels of OxPL/apoB and OxPL/apo(a) varied significantly (>25×) among subjects and also strongly correlated with Lp(a) levels. In contrast, OxPL/plasminogen levels were distributed across a relatively narrow range and did not correlate with Lp(a). Enzymatic removal of OxPL from plasminogen resulted in a longer lysis time for fibrin clots (16.25 vs. 11.96 min, p = 0.007). In serial measurements over 7 months, OxPL/plasminogen levels did not vary in normal subjects or in patients with stable CVD, but increased acutely over the first month and then slowly decreased to baseline in patients following AMI. CONCLUSIONS These data demonstrate that plasminogen contains covalently bound OxPL that influence fibrinolysis. OxPL/plasminogen represent a second major plasma pool of OxPL, in addition to those present on Lp(a). OxPL present on plasminogen may have pathophysiological implications in AMI and atherothrombosis.
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von Zychlinski A, Kleffmann T, Williams MJA, McCormick SP. Proteomics of Lipoprotein(a) identifies a protein complement associated with response to wounding. J Proteomics 2011; 74:2881-91. [PMID: 21802535 DOI: 10.1016/j.jprot.2011.07.008] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2011] [Revised: 07/06/2011] [Accepted: 07/11/2011] [Indexed: 10/18/2022]
Abstract
Lipoprotein(a) [Lp(a)] is a major independent risk factor for cardiovascular disease. Twenty percent of the general population exhibit levels above the risk threshold highlighting the importance for clinical and basic research. Comprehensive proteomics of human Lp(a) will provide significant insights into Lp(a) physiology and pathogenicity. Using liquid chromatography-coupled mass spectrometry, we established a high confidence Lp(a) proteome of 35 proteins from highly purified particles. Protein interaction network analysis and functional clustering revealed proteins assigned to the two major biological processes of lipid metabolism and response to wounding. The latter includes the processes of coagulation, complement activation and inflammatory response. Furthermore, absolute protein quantification of apoB-100, apo(a), apoA1, complement C3 and PON1 gave insights into the compositional stoichiometry of associated proteins per particle. Our proteomics study has identified Lp(a)-associated proteins that support a suggested role of Lp(a) in response to wounding which points to mechanisms of Lp(a) pathogenicity at sites of vascular injury and atherosclerotic lesions. This study has identified a high confidence Lp(a) proteome and provides an important basis for further comparative and quantitative analyses of Lp(a) isolated from greater numbers of plasma samples to investigate the significance of associated proteins and their dynamics for Lp(a) pathogenicity.
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Sukhwal A, Bhattacharyya M, Vishveshwara S. Network approach for capturing ligand-induced subtle global changes in protein structures. ACTA CRYSTALLOGRAPHICA SECTION D: BIOLOGICAL CRYSTALLOGRAPHY 2011; 67:429-39. [PMID: 21543845 DOI: 10.1107/s0907444911007062] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/06/2010] [Accepted: 02/24/2011] [Indexed: 01/12/2023]
Abstract
Ligand-induced conformational changes in proteins are of immense functional relevance. It is a major challenge to elucidate the network of amino acids that are responsible for the percolation of ligand-induced conformational changes to distal regions in the protein from a global perspective. Functionally important subtle conformational changes (at the level of side-chain noncovalent interactions) upon ligand binding or as a result of environmental variations are also elusive in conventional studies such as those using root-mean-square deviations (r.m.s.d.s). In this article, the network representation of protein structures and their analyses provides an efficient tool to capture these variations (both drastic and subtle) in atomistic detail in a global milieu. A generalized graph theoretical metric, using network parameters such as cliques and/or communities, is used to determine similarities or differences between structures in a rigorous manner. The ligand-induced global rewiring in the protein structures is also quantified in terms of network parameters. Thus, a judicious use of graph theory in the context of protein structures can provide meaningful insights into global structural reorganizations upon perturbation and can also be helpful for rigorous structural comparison. Data sets for the present study include high-resolution crystal structures of serine proteases from the S1A family and are probed to quantify the ligand-induced subtle structural variations.
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Affiliation(s)
- Anshul Sukhwal
- Molecular Biophysics Unit, Indian Institute of Science, Bangalore 560012, India
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Nordestgaard BG, Chapman MJ, Ray K, Borén J, Andreotti F, Watts GF, Ginsberg H, Amarenco P, Catapano A, Descamps OS, Fisher E, Kovanen PT, Kuivenhoven JA, Lesnik P, Masana L, Reiner Z, Taskinen MR, Tokgözoglu L, Tybjærg-Hansen A. Lipoprotein(a) as a cardiovascular risk factor: current status. Eur Heart J 2010; 31:2844-53. [PMID: 20965889 PMCID: PMC3295201 DOI: 10.1093/eurheartj/ehq386] [Citation(s) in RCA: 1253] [Impact Index Per Article: 89.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Revised: 08/17/2010] [Accepted: 09/24/2010] [Indexed: 01/15/2023] Open
Abstract
AIMS The aims of the study were, first, to critically evaluate lipoprotein(a) [Lp(a)] as a cardiovascular risk factor and, second, to advise on screening for elevated plasma Lp(a), on desirable levels, and on therapeutic strategies. METHODS AND RESULTS The robust and specific association between elevated Lp(a) levels and increased cardiovascular disease (CVD)/coronary heart disease (CHD) risk, together with recent genetic findings, indicates that elevated Lp(a), like elevated LDL-cholesterol, is causally related to premature CVD/CHD. The association is continuous without a threshold or dependence on LDL- or non-HDL-cholesterol levels. Mechanistically, elevated Lp(a) levels may either induce a prothrombotic/anti-fibrinolytic effect as apolipoprotein(a) resembles both plasminogen and plasmin but has no fibrinolytic activity, or may accelerate atherosclerosis because, like LDL, the Lp(a) particle is cholesterol-rich, or both. We advise that Lp(a) be measured once, using an isoform-insensitive assay, in subjects at intermediate or high CVD/CHD risk with premature CVD, familial hypercholesterolaemia, a family history of premature CVD and/or elevated Lp(a), recurrent CVD despite statin treatment, ≥3% 10-year risk of fatal CVD according to European guidelines, and/or ≥10% 10-year risk of fatal + non-fatal CHD according to US guidelines. As a secondary priority after LDL-cholesterol reduction, we recommend a desirable level for Lp(a) <80th percentile (less than ∼50 mg/dL). Treatment should primarily be niacin 1-3 g/day, as a meta-analysis of randomized, controlled intervention trials demonstrates reduced CVD by niacin treatment. In extreme cases, LDL-apheresis is efficacious in removing Lp(a). CONCLUSION We recommend screening for elevated Lp(a) in those at intermediate or high CVD/CHD risk, a desirable level <50 mg/dL as a function of global cardiovascular risk, and use of niacin for Lp(a) and CVD/CHD risk reduction.
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Affiliation(s)
- Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, DK-2730 Herlev, Denmark.
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Seimon TA, Nadolski MJ, Liao X, Magallon J, Nguyen M, Feric NT, Koschinsky ML, Harkewicz R, Witztum JL, Tsimikas S, Golenbock D, Moore KJ, Tabas I. Atherogenic lipids and lipoproteins trigger CD36-TLR2-dependent apoptosis in macrophages undergoing endoplasmic reticulum stress. Cell Metab 2010; 12:467-82. [PMID: 21035758 PMCID: PMC2991104 DOI: 10.1016/j.cmet.2010.09.010] [Citation(s) in RCA: 343] [Impact Index Per Article: 24.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2010] [Revised: 07/09/2010] [Accepted: 08/02/2010] [Indexed: 02/06/2023]
Abstract
Macrophage apoptosis in advanced atheromata, a key process in plaque necrosis, involves the combination of ER stress with other proapoptotic stimuli. We show here that oxidized phospholipids, oxidized LDL, saturated fatty acids (SFAs), and lipoprotein(a) trigger apoptosis in ER-stressed macrophages through a mechanism requiring both CD36 and Toll-like receptor 2 (TLR2). In vivo, macrophage apoptosis was induced in SFA-fed, ER-stressed wild-type but not Cd36⁻(/)⁻ or Tlr2⁻(/)⁻ mice. For atherosclerosis, we combined TLR2 deficiency with that of TLR4, which can also promote apoptosis in ER-stressed macrophages. Advanced lesions of fat-fed Ldlr⁻(/)⁻ mice transplanted with Tlr4⁻(/)⁻Tlr2⁻(/)⁻ bone marrow were markedly protected from macrophage apoptosis and plaque necrosis compared with WT →Ldlr⁻(/)⁻ lesions. These findings provide insight into how atherogenic lipoproteins trigger macrophage apoptosis in the setting of ER stress and how TLR activation might promote macrophage apoptosis and plaque necrosis in advanced atherosclerosis.
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Affiliation(s)
- Tracie A Seimon
- Department of Medicine, Columbia University, New York, NY 10032, USA
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Hasumi K, Yamamichi S, Harada T. Small-molecule modulators of zymogen activation in the fibrinolytic and coagulation systems. FEBS J 2010; 277:3675-87. [PMID: 20718867 DOI: 10.1111/j.1742-4658.2010.07783.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
The coagulation and fibrinolytic systems are central to the hemostatic mechanism, which works promptly on vascular injury and tissue damage. The rapid response is generated by specific molecular interactions between components in these systems. Thus, the regulation mechanism of the systems is programmed in each component, as exemplified by the elegant processes in zymogen activation. This review describes recently identified small molecules that modulate the activation of zymogens in the fibrinolytic and coagulation systems.
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Affiliation(s)
- Keiji Hasumi
- Department of Applied Biological Science, Tokyo Noko University, Tokyo, Japan.
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Baños-González M, Peña-Duque M, Anglés-Cano E, Martinez-Rios M, Bahena A, Valente-Acosta B, Cardoso-Saldaña G, Angulo-Ortíz J, de la Peña-Díaz A. Apo(a) phenotyping and long-term prognosis for coronary artery disease. Clin Biochem 2010; 43:640-4. [DOI: 10.1016/j.clinbiochem.2010.01.013] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2009] [Revised: 01/26/2010] [Accepted: 01/27/2010] [Indexed: 11/16/2022]
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