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Li Y, Wang W, Yang H, Guo W, Feng J, Yang D, Guo L, Tan G. Negative correlation between early recovery and lipoprotein-associated phospholipase A2 levels after intravenous thrombolysis. J Int Med Res 2022; 50:3000605221093303. [PMID: 35441552 PMCID: PMC9047848 DOI: 10.1177/03000605221093303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Objective Lipoprotein-associated phospholipase A2 (Lp-PLA2) is considered a biomarker
for systemic inflammation and the risk of myocardial infarction and stroke.
However, little is known about the effect of acute vascular events on marker
levels. The purpose of this study was to assess the potential association of
early recovery with Lp-PLA2 levels in patients with acute ischemic stroke
(AIS) after intravenous thrombolysis (IVT). Methods Forty-three consecutive AIS patients who had their first stroke and were
hospitalized within 5 hours of the onset of stroke were enrolled. All
patients were treated with IVT using alteplase or urokinase. Plasma Lp-PLA2
levels were measured within 24 hours after IVT. Variables that showed a
significant association with Lp-PLA2 in univariate analysis were included in
the multivariate ordered logistic regression model. Results Early recovery was associated with Lp-PLA2 levels after IVT, and Lp-PLA2
levels tended to decrease with increased probability of early recovery. This
study is the first to report a negative correlation between early recovery
and Lp-PLA2 levels after IVT. Conclusion Early recovery after IVT was negatively correlated with Lp-PLA2 A2
levels.
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Affiliation(s)
- Yanzheng Li
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000, China.,Department of Neurology, North China University of Science and Technology Affiliated Hospital, North China University of Science and Technology, Tangshan, Hebei Province 063000, China
| | - Wei Wang
- Department of Radiotherapy and Chemotherapy, Tangshan People's Hospital, Tangshan, Hebei Province 063000, China
| | - Hang Yang
- Department of Neurology, North China University of Science and Technology Affiliated Hospital, North China University of Science and Technology, Tangshan, Hebei Province 063000, China
| | - Weiheng Guo
- Department of Statistics, Hebei Medical University, Shijiazhuang, Hebei Province 050000, China
| | - Jingyu Feng
- Department of Neurology, North China University of Science and Technology Affiliated Hospital, North China University of Science and Technology, Tangshan, Hebei Province 063000, China
| | - Dejiu Yang
- Department of Neurology, North China University of Science and Technology Affiliated Hospital, North China University of Science and Technology, Tangshan, Hebei Province 063000, China
| | - Li Guo
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000, China
| | - Guojun Tan
- Department of Neurology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei Province 050000, China
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2
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Chen C, Zhu J, Deng X, Yang Z, Lin W, Ma Y, Huang S, Chen L, Liu Y, Zhu F. Severe periodontitis is associated with the serum levels of hypersensitive C reactive protein and lipoprotein-associated phospholipase A2 in the patients of acute ischemic stroke. J Clin Neurosci 2021; 88:232-236. [PMID: 33992190 DOI: 10.1016/j.jocn.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/23/2021] [Accepted: 04/04/2021] [Indexed: 02/05/2023]
Abstract
BACKGROUND Periodontitis is associated with the pathogenesis of atherosclerotic plaque, and hypersensitive C reactive protein (hs-CRP) and lipoprotein-associated phospholipase A2 (Lp-PLA2) are the serum biomarkers of the stability of atherosclerotic plaque. Whether periodontitis is associated with the serum level of hs-CRP and Lp-PLA2 of acute ischemic stroke remains unclear. MATERIAL AND METHODS We recruited 103 cases with acute ischemic stroke within 7 days after stroke onset. Pocket depth and clinical attachment loss were assessed by oral examination to define the severe periodontitis. Demographic information including gender, age and body weight index, income level, education level, past medical history include smoking history, drinking history, ischemic stroke history, coronary heart disease, hypertension, diabetes and hyperlipidemia were collected, and serum biomarkers including white blood cell (WBC), fibrinogen, total cholesterol (TC), triglyceride (TG), lower density lipoprotein (LDL-C), high density lipoprotein (HDL-C), hs-CRP, HemoglobinA1c (HbAlc), Homocysteine (HCY) and Lp-PLA2 were tested. RESULTS 65 (63.1%) cases were diagnosed as severe periodontitis. Severe periodontitis group showed more male, age, drinking history, higher levels of hs-CRP and Lp-PLA2. Multivariate logistic regression showed that severe periodontitis was were significantly associated with hs-CRP (OR = 2.367, 95%CI: 1.182-4.738; P = .015) and Lp-PLA2 (OR = 2.577, 95% CI: 1.010-6.574; P = .048). CONCLUSIONS Severe periodontitis is independently associated with the serum Level of hs-CRP and Lp-PLA2 in patients with acute ischemic stroke. Whether the improvement of periodontitis could decrease the occurrence and re-occurrence of ischemic stroke by stablizating atherosclerotic plaque need be further studied in future.
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Affiliation(s)
- Chunchun Chen
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China; Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Jinhua Zhu
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Xuhui Deng
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Zhi Yang
- Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China
| | - Weifeng Lin
- Department of Psychiatry, The First Affiliated Hospital of Jinan University, Guangzhou City, Guangdong Province 510632, PR China
| | - Ying Ma
- Department of Cardiology, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China
| | - Shuxuan Huang
- Department of Neurology, People 's Hospital of Guangxi Zhuang Autonomous Region, Nanning, Guangxi 530021, PR China
| | - Lue Chen
- Department of Neurology, Shunde Hospital of Southern Medical University, Shunde, Guangdong Province 528300, PR China
| | - Yuan Liu
- Department of Neurology, The Third People's Hospital of Hangzhou, Hangzhou, Zhejiang Province 310009, PR China
| | - Feiqi Zhu
- Cognitive Impairment Ward of Neurology Department, The Third Affiliated Hospital of Shenzhen University Medical College, Shenzhen City, Guangdong Province 518001, PR China; Department of Neurology, The Affiliated Yuebei People's Hospital of Shantou University Medical College, Shaoguan, Guangdong Province 512025, PR China.
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Fras Z, Tršan J, Banach M. On the present and future role of Lp-PLA 2 in atherosclerosis-related cardiovascular risk prediction and management. Arch Med Sci 2021; 17:954-964. [PMID: 34336025 PMCID: PMC8314407 DOI: 10.5114/aoms.2020.98195] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/10/2020] [Accepted: 02/02/2020] [Indexed: 12/23/2022] Open
Abstract
Circulating concentration and activity of secretory phospholipase A2 (sPLA2) and lipoprotein-associated phospholipase A2 (Lp-PLA2) have been proven as biomarkers of increased risk of atherosclerosis-related cardiovascular disease (ASCVD). Lp-PLA2 might be part of the atherosclerotic process and may contribute to plaque destabilisation through inflammatory activity within atherosclerotic lesions. However, all attempts to translate the inhibition of phospholipase into clinically beneficial ASCVD risk reduction, including in randomised studies, by either non-specific inhibition of sPLA2 (by varespladib) or specific Lp-PLA2 inhibition by darapladib, unexpectedly failed. This gives us a strong imperative to continue research aimed at a better understanding of how Lp-PLA2 and sPLA2 regulate vascular inflammation and atherosclerotic plaque development. From the clinical viewpoint there is a need to establish and validate the existing and emerging novel anti-inflammatory therapeutic strategies to fight against ASCVD development, by using potentially better animal models and differently designed clinical trials in humans.
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Affiliation(s)
- Zlatko Fras
- Centre for Preventive Cardiology, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Chair of Internal Medicine, Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Jure Tršan
- Centre for Preventive Cardiology, Department of Vascular Medicine, Division of Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia
- Medical Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Maciej Banach
- Department of Hypertension, Medical University of Lodz, Poland
- Polish Mother’s Memorial Hospital Research Institute, Lodz, Poland
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Chen YH, Li WC, Chen YC, Yeh WC, Yu W, Hung HY, Jie XX, Chen JY. The correlation between lipoprotein associated phospholipase A 2 and central overweight status. Int J Immunopathol Pharmacol 2021; 35:20587384211048562. [PMID: 34796753 PMCID: PMC8606953 DOI: 10.1177/20587384211048562] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Accepted: 09/01/2021] [Indexed: 11/30/2022] Open
Abstract
OBJECTIVE Being overweight is associated with an increased risk of diabetes mellitus, hypertension, and cardiovascular disease. Lipoprotein-associated phospholipase A2 (Lp-PLA2) can independently predict the risk of cardiovascular disease. This study is aimed to investigate whether Lp-PLA2 was associated with an overweight status. METHODS This was a cross-sectional study that enrolled 3760 Chinese adults (age, 18-50 years) who underwent medical examination department of Xiamen Chang-Gung Hospital (XCGH) from 2018 to 2020. To explore the distribution of overweight classifications in the Chinese population, we evaluated the correlation of the overweight status with Lp-PLA2, after correcting for possible influencing factors. RESULTS The Lp-PLA2 level was greater in male than in female subjects (p < 0.001). Subjects with a central overweight status had a greater Lp-PLA2 level than those with normal weight and a peripheral overweight status, in both male and female cohorts. The Lp-PLA2 level was significantly greater in those with additional comorbidities (namely diabetes mellitus (DM), hypertension (HTN), overweight, and metabolic syndrome (MetS)). The age-adjusted and LDL-adjusted Lp-PLA2 level also was significantly higher in the DM (+) and HTN (-) subgroups than in the DM (-), HTN (-), DM (-), and HTN (+) subgroups. CONCLUSION Lp-PLA2 is associated with sex, central overweight status, diabetes, hypertension, and MetS in adults aged < 50 years and the age-adjusted and LDL-adjusted Lp-PLA2 was significantly higher in the DM (+) and HTN (-) subgroups than in the DM (-) and HTN (-) and DM (-) and HTN (+) subgroups.
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Affiliation(s)
- Yi-Hsuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wen-Cheng Li
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Yi-Chuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei-Chung Yeh
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Wei Yu
- Department of Health Management, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Hsiung Ying Hung
- Department of Pulmonary and Critical Care Medicine, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Xiong-Xue Jie
- Department of Oncology, Xiamen Chang-Gung Hospital, Xiamen, China
| | - Jau-Yuan Chen
- Department of Family Medicine, Chang Gung Memorial Hospital, Linkou, Taoyuan, Taiwan
- College of Medicine, Chang Gung University, Taoyuan, Taiwan
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5
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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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6
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Increased activity of lipoprotein-associated phospholipase A 2 in non-severe asthma. Allergol Int 2019; 68:450-455. [PMID: 31064688 DOI: 10.1016/j.alit.2019.04.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Revised: 03/19/2019] [Accepted: 04/03/2019] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Given increased risk of cardiovascular events in asthma we hypothesized that lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzyme involved in atherosclerosis, is associated with proinflammatory and prothrombotic blood alterations in this disease. METHODS In 164 adult asthmatics (63 with severe asthma) we measured plasma Lp-PLA2 activity using the PLAC test. We determined its relations to inflammation and prothrombotic blood alterations. RESULTS In asthma, Lp-PLA2 was inversely related to the age (β = -0.1 [-0.18 to -0.02]) and was lower in women (n = 122 [74%], 205 [182-242] vs. 243 [203-262] nmol/min/ml, p = 0.001). Interestingly, Lp-PLA2 correlated negatively with the asthma severity score (β = -0.15 [-0.23 to -0.07]), being 10.3% higher in those with non-severe (mild or moderate) asthma (n = 101, 62%) as compared to the severe disease subtype (224 [191-261] vs. 203 [181-229], p = 0.006 after adjustment for potential confounders). Lp-PLA2 activity was positively related to the levels of low-density lipoprotein (β = 0.1 [0.02-0.18]), triglycerides (β = 0.11 [0.03-0.19]) and glucose (β = 0.1 [0.02-0.18]) and inversely to the tumor necrosis factor α (β = -0.27 [-0.35 to -0.2]), high sensitivity C-reactive protein (β = -0.1 [-0.19 to -0.02]) and fibrinogen (β = -0.12 [-0.21 to -0.03]), as well as prothrombin (β = -0.16 [-0.24 to -0.08]), and parameters describing thrombin generation potential, such as endogenous thrombin potential (β = -0.14 [-0.21 to -0.06]) and peak thrombin generated (β = -0.2 [-0.28 to -0.12]). CONCLUSIONS Elevated Lp-PLA2 activity in non-severe asthmatics suggests increased atherosclerotic risk in this group. Lower Lp-PLA2 activity accompanied by its inverse relationship to inflammatory or prothrombotic blood biomarkers observed in turn in severe asthmatics might be related to the pathogenesis of more severe asthma phenotype.
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7
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Mishra N, Mohata M, Narang R, Lakshmy R, Hazarika A, Pandey RM, Das N, Luthra K. Altered Expression of Complement Regulatory Proteins CD35, CD46, CD55, and CD59 on Leukocyte Subsets in Individuals Suffering From Coronary Artery Disease. Front Immunol 2019; 10:2072. [PMID: 31555286 PMCID: PMC6727527 DOI: 10.3389/fimmu.2019.02072] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2019] [Accepted: 08/16/2019] [Indexed: 12/16/2022] Open
Abstract
Studies conducted in animal models have suggested that membrane complement regulatory proteins play an important role in the pathophysiology of coronary artery disease (CAD). In this study, a total of 100 individuals, with stable CAD and 100 healthy controls, both groups predominantly male, were recruited. We evaluated the plasma levels of complement regulatory proteins (Cregs) CD35, CD46, CD55, and CD59 and their surface expression on granulocytes, lymphocytes, and monocytes by flow cytometry. The mRNA expression of these Cregs in total leukocytes was determined by quantitative PCR. The soluble forms of Cregs, C3c, Mannose binding protein-associated serine protease 2 (MASP-2), Platelet activating factor-acetyl hydrolase (PAF-AH), and inflammatory cytokines were quantified by ELISA. High plasma levels of C3c, indicative of complement activation, in addition to significantly low levels of Cregs, were observed in CAD patients. A significantly lower expression of CD46 and CD55 on the surface of lymphocytes, monocytes, and granulocytes and higher surface expression of CD35 and CD59 on granulocytes (p < 0.0001) was seen in CAD patients as compared to healthy donors. The high expression of CD59 on granulocytes positively correlated with the severity of disease and may serve as a potential marker of disease progression in CAD.
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Affiliation(s)
- Nitesh Mishra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Madhav Mohata
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Rajeev Narang
- Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India
| | - R Lakshmy
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Anjali Hazarika
- Blood Bank, Cardio-Neuro Centre, All India Institute of Medical Sciences, New Delhi, India
| | - R M Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Nibhriti Das
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Kalpana Luthra
- Department of Biochemistry, All India Institute of Medical Sciences, New Delhi, India
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8
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Tuten A, Gungor Z, Ekmekci H, Ekmekci OB, Kucur M, Yilmaz N, Donma O, Sonmez H, Acıkgoz A, Madazlı R. Relationship between LPA SNPs and inflammatory burden in patients with preeclampsia to address future cardiovascular risk. J Matern Fetal Neonatal Med 2019; 34:898-906. [PMID: 31113255 DOI: 10.1080/14767058.2019.1622667] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
OBJECTIVE The study tested whether cardiovascular corresponding LPA risk genotypes improve pre-eclampsia and coronary heart disease (CHD) risk prediction beyond conventional risk factors. BACKGROUND Studies have shown that women specific risk factors for cardiovascular disease (CVD) have taken an attention recently. It might be possible to identify women who have the highest risk in developing CVD in their further lives. It is well-known that Lp(a) levels have an impact on increased risk of CVD which is affected by LPA gene. Further, LPA risk genotypes are not considered in cardiovascular risk prediction. METHODS We have included 200 pregnant Turkish women into the study. We stratified the preeclamptic (PE) group: early (EOP) (28.7 ± 3.0 weeks) and late onset (LOP) (36.0 ± 1.4 weeks). 14 LPA SNPs were evaluated in the study. Rs9355296 and rs3798220 were found as independent risk factors for preeclampsia by logistic regression analysis. A positive correlation was found between rs9355296 and the diagnostic criteria of preeclampsia. Further rs9355296 G/* carriers have higher vascular inflammation rather than AA carriers. CONCLUSIONS The findings reveal that LPA genetic variability with high inflammatory response might be an indication of future cardiovascular events.
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Affiliation(s)
- Abdullah Tuten
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Zeynep Gungor
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Hakan Ekmekci
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Ozlem Balci Ekmekci
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Mine Kucur
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Nevin Yilmaz
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Orkide Donma
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Huseyin Sonmez
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Abdullah Acıkgoz
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
| | - Rıza Madazlı
- Faculty of Medicine, University of Istanbul, Cerrahpasa Medical School, Istanbul, Turkey
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Characterization of PLAC® tests in the quantization of lipoprotein associated phospholipase A 2 for assessment of cardiovascular diseases. Clin Chim Acta 2018; 487:222-227. [PMID: 30296441 DOI: 10.1016/j.cca.2018.10.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Revised: 09/28/2018] [Accepted: 10/03/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND PLAC® mass test (diaDexus, Inc.) does not detect all Lp-PLA2 proteins in the circulation. The total circulating Lp-PLA2 mass can be quantized by using the CHAPS modified PLAC® mass test. To compare the difference of the PLAC® mass, CHAPS modified PLAC® mass and PLAC® activity tests in risk assessment of CVD, the 3 Lp-PLA2 quantization methods were characterized using a collection of serum and plasma from CVD patents and matched non-symptomatic controls. Improvement on risk assessment for ischemic stroke by Lp-PLA2 and lipids were also investigated. METHODS Ninety one human sera and plasma from elderly patients with first CVD incidents and 78 matched controls were collected at clinics. Lp-PLA2 was assessed by PLAC® mass, CHAPS modified PLAC® mass and PLAC® activity tests and data were subjected to statistical analyses. Correlation with lipid cholesterols or Apo proteins was compared for all formats of PLAC® tests. Ratios of Lp-PLA2 by different PLAC® tests to different lipids were assessed for synergistic enhancement in the indication of ischemic stroke. RESULTS The PLAC® mass test was superior to other formats of PLAC® tests in the assessment of CVD and is independent of lipids. The Lp-PLA2 by the CHAPS modified PLAC® mass test has no separation between the CVD and control groups. CONCLUSIONS Both PLAC® mass and PLAC® activity tests are effective but the CHAPS modified PLAC® mass test has no or less utility in the risk assessment of CVD. The ratio of Lp-PLA2 by either PLAC® mass or PLAC® activity over ApoA1 or (Apo A1 + Apo B) synergistically enhance the risk assessment power for ischemic stroke.
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10
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Garg PK, Bartz TM, Norby FL, Jorgensen NW, McClelland RL, Ballantyne CM, Chen LY, Gottdiener JS, Greenland P, Hoogeveen R, Jenny NS, Kizer JR, Rosenson RS, Soliman EZ, Cushman M, Alonso A, Heckbert SR. Association of lipoprotein-associated phospholipase A 2 and risk of incident atrial fibrillation: Findings from 3 cohorts. Am Heart J 2018; 197:62-69. [PMID: 29447785 PMCID: PMC5860682 DOI: 10.1016/j.ahj.2017.11.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2017] [Accepted: 11/28/2017] [Indexed: 12/31/2022]
Abstract
BACKGROUND Multiple prospective studies have established an association between inflammation and higher risk of atrial fibrillation (AF), but the association between lipoprotein-associated phospholipase A2 (Lp-PLA2) mass and activity and incident AF has not been extensively evaluated. METHODS Using data from 10,794 Atherosclerosis Risk In Communities (ARIC) study participants aged 53-75 years, 5,181 Cardiovascular Health Study (CHS) participants aged 65 to 100 years, and 5,425 Multi-Ethnic Study of Atherosclerosis (MESA) participants aged 45-84 years, we investigated the association between baseline Lp-PLA2 levels and the risk of developing AF. Incident AF was identified in each cohort by follow-up visit electrocardiograms, hospital discharge coding of AF, or Medicare claims data. RESULTS Over a mean of 13.1, 11.5, and 10.0 years of follow-up, 1,439 (13%), 2,084 (40%), and 615 (11%) incident AF events occurred in ARIC, CHS, and MESA, respectively. In adjusted analyses, each SD increment in Lp-PLA2 activity was associated with incident AF in both ARIC (hazard ratio [HR] 1.13, 95% CI 1.06-1.20) and MESA (HR 1.24, 95% CI 1.05-1.46). Each SD increment in Lp-PLA2 mass was also associated with incident AF in MESA (HR 1.25, 95% CI 1.11-1.41). No significant associations were observed among CHS participants. CONCLUSIONS Although higher Lp-PLA2 mass and activity were associated with development of AF in ARIC and MESA, this relationship was not observed in CHS, a cohort of older individuals.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, Keck School of Medicine, University of Southern California, Los Angeles, CA.
| | - Traci M Bartz
- Department of Biostatistics, University of Washington, Seattle, WA
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN
| | - Neal W Jorgensen
- Department of Biostatistics, University of Washington, Seattle, WA
| | | | - Christie M Ballantyne
- Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX; The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX
| | - Lin Y Chen
- Cardiovascular Division, University of Minnesota Medical School, Minneapolis, MN
| | - John S Gottdiener
- Division of Cardiology, University of Maryland School of Medicine, Baltimore, MD
| | - Philip Greenland
- Departments of Preventive Medicine and Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Ron Hoogeveen
- Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX; The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX
| | - Nancy S Jenny
- Department of Pathology, Larner College of Medicine at the University of Vermont, Burlington, VT
| | - Jorge R Kizer
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY; Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY
| | - Robert S Rosenson
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Elsayed Z Soliman
- Epidemiological Cardiology Research Center (EPICARE), Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC; Department of Medicine, Section on Cardiology, Wake Forest School of Medicine, Winston-Salem, NC
| | - Mary Cushman
- Department of Pathology, Larner College of Medicine at the University of Vermont, Burlington, VT; Department of Medicine, Cardiovascular Research Institute, Larner College of Medicine at the University of Vermont College of Medicine, Burlington, VT
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA
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11
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Garg PK, Norby FL, Polfus LM, Boerwinkle E, Gibbs RA, Grove ML, Folsom AR, Garimella PS, Matsushita K, Hoogeveen RC, Ballantyne CM. Lipoprotein-associated phospholipase A 2 and risk of incident peripheral arterial disease: Findings from The Atherosclerosis Risk in Communities study (ARIC). Atherosclerosis 2017; 268:12-18. [PMID: 29169030 DOI: 10.1016/j.atherosclerosis.2017.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/13/2017] [Accepted: 11/10/2017] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Results from prospective studies evaluating the relationship between elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) activity and incident peripheral arterial disease (PAD) have been mixed. We investigated whether higher Lp-PLA2 levels are associated with increased risk of incident PAD and whether PLA2G7 gene variants, which result in lower Lp-PLA2 levels, are associated with reduced risk of incident PAD. METHODS Our analysis included 9922 participants (56% female; 21% African-American; mean age 63 years) without baseline PAD at ARIC Visit 4 (1996-1998), who had Lp-PLA2 activity measured and were subsequently followed for the development of PAD, defined by occurrence of a PAD-related hospitalization, through 2012. Cox proportional hazard models were performed to determine the association of Lp-PLA2 levels and PLA2G7 gene variants with incident PAD. RESULTS During a median follow-up of 14.9 years, we identified 756 incident cases of PAD. In analyses adjusting for age, race, and sex, each standard deviation increment in Lp-PLA2 activity (62 nmol/ml/min) was associated with a higher risk of developing PAD (hazard ratio (HR) 1.17; 95% confidence interval (CI) 1.09, 1.26). This association remained significant after additional adjustment for risk factors, other cardiovascular disease, and medication use, but was strongly attenuated (HR: 1.09; 95% CI 1.00, 1.20). PLA2G7 variants were not associated with a lower risk of PAD in both white carriers (HR: 1.21; 95% CI: 0.17-8.56) and African-American carriers (HR: 0.83; 95% CI: 0.41-1.67), although statistical power was quite limited for this analysis, particularly in whites. CONCLUSIONS While higher Lp-PLA2 activity was associated with an increased risk for incident PAD, it is likely a risk marker largely represented by traditional risk factors.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, University of Southern California Keck School of Medicine, Los Angeles, CA, USA.
| | - Faye L Norby
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Linda M Polfus
- University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Eric Boerwinkle
- University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Richard A Gibbs
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA
| | - Megan L Grove
- University of Texas Health Sciences Center at Houston, Houston, TX, USA
| | - Aaron R Folsom
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Pranav S Garimella
- Division of Nephrology-Hypertension, University of California San Diego, La Jolla, CA, USA
| | - Kunihiro Matsushita
- Department of Epidemiology, The Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ron C Hoogeveen
- Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA; The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX, USA
| | - Christie M Ballantyne
- Section of Atherosclerosis and Vascular Medicine, Baylor College of Medicine, Houston, TX, USA; The Center for Cardiovascular Disease Prevention, Methodist DeBakey Heart Center, Houston, TX, USA
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12
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Otsuka F, Zhao X, Trout HH, Qiao Y, Wasserman BA, Nakano M, Macphee CH, Brandt M, Krug-Gourley S, Guo L, Ladich ER, Cheng Q, Davis HR, Finn AV, Virmani R, Kolodgie FD. Community-based statins and advanced carotid plaque: Role of CD163 positive macrophages in lipoprotein-associated phospholipase A 2 activity in atherosclerotic plaque. Atherosclerosis 2017; 267:78-89. [PMID: 29101839 DOI: 10.1016/j.atherosclerosis.2017.10.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2017] [Revised: 10/09/2017] [Accepted: 10/12/2017] [Indexed: 02/04/2023]
Abstract
BACKGROUND AND AIMS Lipoprotein-associated phospholipase A2 (Lp-PLA2), an enzymatic inflammatory biomarker primarily bound to low-density lipoprotein cholesterol, is associated with an approximate twofold increased risk of cardiovascular disease and stroke. Despite indications that circulating Lp-PLA2 is sensitive to statins, it remains largely unknown whether statin usage exerts local effects on Lp-PLA2 expression at the site of atheromatous plaque. METHODS Carotid plaques (n = 38) were prospectively collected from symptomatic (n = 18) and asymptomatic (n = 20) patients with (n = 20) or without (n = 18) documented statin history. In all cases, endarterectomy was performed where the primary stenosis was removed in an undisturbed manner. Serial cryosections of the presenting lesion were assessed histologically for macrophages, Lp-PLA2, and cell death (apoptotic index). RESULTS Symptomatic lesions exhibited less calcification, with greater inflammation characterized by increased expression of CD68+ and CD163+ macrophage subsets, and Lp-PLA2. Symptomatic plaques also exhibited greater necrotic core area and increased apoptosis, as compared with asymptomatic lesions. In contrast, statin treatment did not appear to influence any of these parameters, except for the extent of apoptosis, which was less in statin treated as compared with statin naïve lesions. Overall, Lp-PLA2 expression correlated positively with necrotic core area, CD68+ and CD163+ macrophage area, and cell death. Finally, in vitro assays and dual immunofluorescence staining confirmed CD163-expressing monocytes/macrophages are also a major source of Lp-PLA2. CONCLUSIONS Statin treatment has no effect on local atherosclerotic lesion Lp-PLA2 activity, therefore, the addition of anti-inflammatory treatments to further decrease macrophage Lp-PLA2 expression in atherosclerotic lesions may reduce lesional inflammation and cell death, and prevent necrotic core expansion and lesion progression.
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Affiliation(s)
| | | | - Hugh H Trout
- Department of Surgery, Suburban Hospital, Bethesda, MD, USA
| | - Ye Qiao
- Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, USA
| | - Bruce A Wasserman
- Department of Radiology and Radiological Sciences, The Johns Hopkins Hospital, Baltimore, MD, USA
| | | | | | | | | | - Liang Guo
- CVPath Institute, Inc., Gaithersburg, MD, USA
| | | | - Qi Cheng
- CVPath Institute, Inc., Gaithersburg, MD, USA
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13
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Goliasch G, Silbernagel G, Kleber ME, Grammer TB, Pilz S, Tomaschitz A, Bartko PE, Maurer G, Koenig W, Niessner A, März W. Refining Long-Term Prediction of Cardiovascular Risk in Diabetes - The VILDIA Score. Sci Rep 2017; 7:4700. [PMID: 28680124 PMCID: PMC5498499 DOI: 10.1038/s41598-017-04935-8] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 05/17/2017] [Indexed: 01/06/2023] Open
Abstract
Cardiovascular risk assessment in patients with diabetes relies on traditional risk factors. However, numerous novel biomarkers have been found to be independent predictors of cardiovascular disease, which might significantly improve risk prediction in diabetic patients. We aimed to improve prediction of cardiovascular risk in diabetic patients by investigating 135 evolving biomarkers. Based on selected biomarkers a clinically applicable prediction algorithm for long-term cardiovascular mortality was designed. We prospectively enrolled 864 diabetic patients of the LUdwigshafen RIsk and Cardiovascular health (LURIC) study with a median follow-up of 9.6 years. Independent risk factors were selected using bootstrapping based on a Cox regression analysis. The following seven variables were selected for the final multivariate model: NT-proBNP, age, male sex, renin, diabetes duration, Lp-PLA2 and 25-OH vitamin D3. The risk score based on the aforementioned variables demonstrated an excellent discriminatory power for 10-year cardiovascular survival with a C-statistic of 0.76 (P < 0.001), which was significantly better than the established UKPDS risk engine (C-statistic = 0.64, P < 0.001). Net reclassification confirmed a significant improvement of individual risk prediction by 22% (95% confidence interval: 14–30%) compared to the UKPDS risk engine (P < 0.001). The VILDIA score based on traditional cardiovascular risk factors and reinforced with novel biomarkers outperforms previous risk algorithms.
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Affiliation(s)
- Georg Goliasch
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria.
| | - Günther Silbernagel
- Department of Internal Medicine, Division of Angiology, Medical University of Graz, Graz, Austria
| | - Marcus E Kleber
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Tanja B Grammer
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | - Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Metabolism, Medical University of Graz, Graz, Austria
| | - Andreas Tomaschitz
- Bad Gleichenberg Clinic, Bad Gleichenberg, Austria.,Department of Internal Medicine, Division of Cardiology, Medical University of Graz, Graz, Austria
| | - Philipp E Bartko
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Gerald Maurer
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Wolfgang Koenig
- Deutsches Herzzentrum München, Teschnische Universität München, Munich, Germany.,DZHK (German Centre of Cardiovascular Research), partner site Munich Heart Alliance, Munich, Germany.,Department of Internal Medicine, Division of Cardiology, University of Ulm, Ulm, Germany
| | - Alexander Niessner
- Division of Cardiology, Department of Internal Medicine II, Medical University of Vienna, Vienna, Austria
| | - Winfried März
- Medical Clinic V (Nephrology, Hypertensiology, Endocrinology, Diabetology, Rheumatology), Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany.,Clinical Institute of Medical and Chemical Laboratory Diagnostics, Medical University of Graz, Graz, Austria.,Synlab Academy, Synlab Services GmbH, Mannheim, Germany
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14
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Rolfes MC, Juhn YJ, Wi CI, Sheen YH. Asthma and the Risk of Rheumatoid Arthritis: An Insight into the Heterogeneity and Phenotypes of Asthma. Tuberc Respir Dis (Seoul) 2017; 80:113-135. [PMID: 28416952 PMCID: PMC5392483 DOI: 10.4046/trd.2017.80.2.113] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2016] [Revised: 12/03/2016] [Accepted: 12/08/2016] [Indexed: 01/05/2023] Open
Abstract
Asthma is traditionally regarded as a chronic airway disease, and recent literature proves its heterogeneity, based on distinctive clusters or phenotypes of asthma. In defining such asthma clusters, the nature of comorbidity among patients with asthma is poorly understood, by assuming no causal relationship between asthma and other comorbid conditions, including both communicable and noncommunicable diseases. However, emerging evidence suggests that the status of asthma significantly affects the increased susceptibility of the patient to both communicable and noncommunicable diseases. Specifically, the impact of asthma on susceptibility to noncommunicable diseases such as chronic systemic inflammatory diseases (e.g., rheumatoid arthritis), may provide an important insight into asthma as a disease with systemic inflammatory features, a conceptual understanding between asthma and asthma-related comorbidity, and the potential implications on the therapeutic and preventive interventions for patients with asthma. This review discusses the currently under-recognized clinical and immunological phenotypes of asthma; specifically, a higher risk of developing a systemic inflammatory disease such as rheumatoid arthritis and their implications, on the conceptual understanding and management of asthma. Our discussion is divided into three parts: literature summary on the relationship between asthma and the risk of rheumatoid arthritis; potential mechanisms underlying the association; and implications on asthma management and research.
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Affiliation(s)
| | - Young Jun Juhn
- Department of Pediatric and Adolescent Medicine/Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - Chung-Il Wi
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA
| | - Youn Ho Sheen
- Department of Pediatric and Adolescent Medicine, Mayo Clinic, Rochester, MN, USA.,Department of Pediatrics, CHA Gangnam Medical Center, CHA University, Seoul, Korea
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15
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Li D, Zhao L, Yu J, Zhang W, Du R, Liu X, Liu Y, Chen Y, Zeng R, Cao Y, Zeng Z, Zhao Z, Wu J. Lipoprotein-associated phospholipase A2 in coronary heart disease: Review and meta-analysis. Clin Chim Acta 2017; 465:22-29. [DOI: 10.1016/j.cca.2016.12.006] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 12/07/2016] [Accepted: 12/08/2016] [Indexed: 01/28/2023]
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16
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Garg PK, Jorgensen NW, McClelland RL, Jenny NS, Criqui MH, Allison MA, Greenland P, Rosenson RS, Siscovick DS, Cushman M. Lipoprotein-associated phospholipase A 2 and risk of incident peripheral arterial disease in a multi-ethnic cohort: The Multi-Ethnic Study of Atherosclerosis. Vasc Med 2016; 22:5-12. [PMID: 28215109 DOI: 10.1177/1358863x16671424] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Prospective studies supporting a relationship between elevated lipoprotein-associated phospholipase A2 (Lp-PLA2) and incident peripheral arterial disease (PAD) are limited. We evaluated the association of Lp-PLA2 with incident PAD in a multi-ethnic cohort without clinical cardiovascular disease. A total of 4622 participants with measurement of Lp-PLA2 mass and Lp-PLA2 activity and an ankle-brachial index (ABI) between 0.9 and 1.4 were followed for the development of PAD (median follow-up = 9.3 years), defined as an ABI ⩽0.9 and decline from baseline ⩾0.15. There were 158 incident PAD events during follow-up. In adjusted logistic regression models, each higher standard deviation of both Lp-PLA2 activity and mass did not confer an increased risk of developing PAD [odds ratios, (95% confidence intervals)]: 0.92 (0.66-1.27) for Lp-PLA2 activity and 1.06 (0.85-1.34) for mass. Additionally, no significant interaction was found according to ethnicity: p=0.43 for Lp-PLA2 activity and p=0.55 for Lp-PLA2 mass. We found no evidence of an association between Lp-PLA2 and incident PAD.
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Affiliation(s)
- Parveen K Garg
- 1 Division of Cardiovascular Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Neal W Jorgensen
- 2 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Robyn L McClelland
- 2 Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Nancy S Jenny
- 3 Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA
| | - Michael H Criqui
- 4 Department of Family Medicine & Public Health, University of California in San Diego, La Jolla, CA, USA
| | - Matthew A Allison
- 4 Department of Family Medicine & Public Health, University of California in San Diego, La Jolla, CA, USA
| | - Philip Greenland
- 5 Department of Medicine, Northwestern University, Chicago, IL, USA.,6 Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Robert S Rosenson
- 7 Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Mary Cushman
- 3 Department of Pathology and Laboratory Medicine, University of Vermont College of Medicine, Burlington, VT, USA.,9 Department of Medicine, University of Vermont College of Medicine, Burlington, VT, USA
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17
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Lee HS, Jung CH, Kim SR, Jang HC, Park CY. Effect of Pitavastatin Treatment on ApoB-48 and Lp-PLA₂ in Patients with Metabolic Syndrome: Substudy of PROspective Comparative Clinical Study Evaluating the Efficacy and Safety of PITavastatin in Patients with Metabolic Syndrome. Endocrinol Metab (Seoul) 2016; 31:120-6. [PMID: 26754586 PMCID: PMC4803547 DOI: 10.3803/enm.2016.31.1.120] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Apolipoprotein (Apo) B-48 is an intestinally derived lipoprotein that is expected to be a marker for cardiovascular disease (CVD). Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a vascular-specific inflammatory marker and important risk predictor of CVD. The aim of this study was to explore the effect of pitavastatin treatment and life style modification (LSM) on ApoB-48 and Lp-PLA₂ levels in metabolic syndrome (MS) patients at relatively low risk for CVD, as a sub-analysis of a previous multi-center prospective study. METHODS We enrolled 75 patients with MS from the PROPIT study and randomized them into two treatment groups: 2 mg pitavastatin daily+intensive LSM or intensive LSM only. We measured the change of lipid profiles, ApoB-48 and Lp-PLA₂ for 48 weeks. RESULTS Total cholesterol, low density lipoprotein cholesterol, non-high density lipoprotein cholesterol, and ApoB-100/A1 ratio were significantly improved in the pitavastatin+LSM group compared to the LSM only group (P≤0.001). Pitavastatin+LSM did not change the level of ApoB-48 in subjects overall, but the level of ApoB-48 was significantly lower in the higher mean baseline value group of ApoB-48. The change in Lp-PLA₂ was not significant after intervention in either group after treatment with pitavastatin for 1 year. CONCLUSION Pitavastatin treatment and LSM significantly improved lipid profiles, ApoB-100/A1 ratio, and reduced ApoB-48 levels in the higher mean baseline value group of ApoB-48, but did not significantly alter the Lp-PLA₂ levels.
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Affiliation(s)
- Hyo Sun Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Hee Jung
- Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Sung Rae Kim
- Department of Endocrinology, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hak Chul Jang
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Cheol Young Park
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea.
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18
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Maiolino G, Bisogni V, Rossitto G, Rossi GP. Lipoprotein-associated phospholipase A2 prognostic role in atherosclerotic complications. World J Cardiol 2015; 7:609-620. [PMID: 26516415 PMCID: PMC4620072 DOI: 10.4330/wjc.v7.i10.609] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Revised: 06/11/2015] [Accepted: 09/28/2015] [Indexed: 02/06/2023] Open
Abstract
Atherosclerosis manifests itself clinically at advanced stages when plaques undergo hemorrhage and/or rupture with superimposed thrombosis, thus abruptly stopping blood supply. Identification of markers of plaque destabilization at a pre-clinical stage is, therefore, a major goal of cardiovascular research. Promising results along this line were provided by studies investigating the lipoprotein-associated phospholipase A2 (Lp-PLA2), a member of phospholipase A2 proteins family that plays a key role in the metabolism of pro-inflammatory phospholipids, as oxidized low-density lipoproteins, and in the generation of pro-atherogenic metabolites, including lysophosphatidylcholine and oxidized free fatty acids. We herein review the experimental and clinical studies supporting use of Lp-PLA2 activity for predicting cardiovascular events. To his end we considered not only Lp-PLA2 activity and mass, but also Lp-PLA2 gene variations and their association with incident coronary artery disease, stroke, and cardiovascular mortality. Based on these evidences the major scientific societies have included in their guidelines the measurement of Lp-PLA2 activity among the biomarkers that are useful in risk stratification of adult asymptomatic patients at intermediate cardiovascular risk. The results of two recently published major clinical trials with the Lp-PLA2 inhibitor darapladib, which seem to challenge the pathogenic role of Lp-PLA2, will also be discussed.
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19
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Platelets in the immune response: Revisiting platelet-activating factor in anaphylaxis. J Allergy Clin Immunol 2015; 135:1424-32. [PMID: 26051949 DOI: 10.1016/j.jaci.2015.04.019] [Citation(s) in RCA: 79] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 04/21/2015] [Accepted: 04/21/2015] [Indexed: 01/09/2023]
Abstract
Anaphylaxis is an acute, severe, life-threatening multisystem allergic reaction resulting from the sudden systemic release of biochemical mediators and chemotactic substances. Release of both preformed granule-associated mediators and newly generated lipid-derived mediators contributes to the amplification and prolongation of anaphylaxis. Platelet-activating factor (PAF) is a potent phospholipid-derived mediator the central role of which has been well established in experimental models of both immune-mediated and non-immune mediated anaphylaxis. It is produced and secreted by several types of cells, including mast cells, monocytes, tissue macrophages, platelets, eosinophils, endothelial cells, and neutrophils. PAF is implicated in platelet aggregation and activation through release of vasoactive amines in the inflammatory response, resulting in increased vascular permeability, circulatory collapse, decreased cardiac output, and various other biological effects. PAF is rapidly hydrolyzed and degraded to an inactive metabolite, lysoPAF, by the enzyme PAF acetylhydrolase, the activity of which has shown to correlate inversely with PAF levels and predispose to severe anaphylaxis. In addition to its role in anaphylaxis, PAF has also been implicated as a mediator in both allergic and nonallergic inflammatory diseases, including allergic rhinitis, sepsis, atherosclerotic disease, and malignancy, in which PAF signaling has an established role. The therapeutic role of PAF antagonism has been investigated for several diseases, with variable results thus far. Further investigation of its role in pathology and therapeutic modulation is highly anticipated because of the pressing need for more selective and targeted therapy for the management of severe anaphylaxis.
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20
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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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21
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Dong L, Qu X, Hu ZG, Peng X, Wang Y, Miao Q, Zhang X. Lipoprotein-associated Phospholipase A2 is Associated with Angiographic Coronary Artery Disease and Coronary Artery Risk Factors in the Elderly. INT J GERONTOL 2015. [DOI: 10.1016/j.ijge.2015.05.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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22
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Maiolino G, Rossitto G, Pedon L, Cesari M, Frigo AC, Azzolini M, Plebani M, Rossi GP. Galectin-3 Predicts Long-Term Cardiovascular Death in High-Risk Patients With Coronary Artery Disease. Arterioscler Thromb Vasc Biol 2015; 35:725-32. [DOI: 10.1161/atvbaha.114.304964] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Objective—
Galectin-3 (Gal-3) can affect atherogenesis by multiple mechanisms, but it remains scarcely known whether plasma Gal-3 levels predict cardiovascular events in patients with coronary artery disease. Therefore, we investigated if Gal-3 predicts cardiovascular death in patients with coronary artery disease of the Genetic and ENvironmental factors In Coronary Artery disease study.
Approach and Results—
In a prospective cohort study, we measured the plasma levels of Gal-3 in 1013 randomly selected patients who underwent coronary angiography and long-term follow-up to assess incident cardiovascular events. The primary end points were (1) cardiovascular death and (2) a composite of cardiovascular death, acute coronary syndrome, and stroke. Secondary end points entailed (1) acute myocardial infarction, (2) stroke, and (3) a composite fatal ischemic event including fatal myocardial infarction and stroke. The effect of Gal-3 on prognosis was assessed using Kaplan–Meier analysis and multivariate Cox’s regression. During long-term follow-up (median, 7.2 years), 115 cardiovascular deaths occurred (15.2%), more commonly in the high Gal-3 tertile (25.2%) than in the intermediate and the low tertiles (13.6% versus 7.5%, respectively;
P
<0.001). The adverse prognostic effect of high Gal-3 was confirmed in subgroup analysis of the patients with angiographically documented coronary artery disease and also of those with a normal left ventricular ejection fraction. At multivariate analysis, Gal-3 was a predictor of cardiovascular mortality (hazard ratio, 1.79; 95% confidence interval, 1.10–2.93;
P
=0.020) along with age, left ventricular ejection fraction, and coronary atherosclerotic burden.
Conclusions—
In high cardiovascular risk patients referred for coronary angiography Gal-3 is a strong independent predictor of cardiovascular death.
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Affiliation(s)
- Giuseppe Maiolino
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Giacomo Rossitto
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Luigi Pedon
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Maurizio Cesari
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Anna Chiara Frigo
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Matteo Azzolini
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Mario Plebani
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
| | - Gian Paolo Rossi
- From the Department of Medicine–DIMED, Clinica dell’Ipertensione Arteriosa UOSD (G.M., G.R., M.C., M.A., G.P.R.), Department of Cardiac, Thoracic, and Vascular Sciences (A.C.F.), and Department of Medicine–DIMED, Laboratory Medicine (M.P.), University of Padua, Padua, Italy; and Dipartimento Area Medica, Divisione di Cardiologia Ospedale di Cittadella, Cittadella, Italy (L.P.)
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Mazereeuw G, Herrmann N, Xu H, Blanchard AP, Figeys D, Oh PI, Bennett SA, Lanctôt KL. Platelet activating factors are associated with depressive symptoms in coronary artery disease patients: a hypothesis-generating study. Neuropsychiatr Dis Treat 2015; 11:2309-14. [PMID: 26379437 PMCID: PMC4567245 DOI: 10.2147/ndt.s87111] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Depression is a frequent complication of coronary artery disease (CAD) with an unknown etiology. Platelet activating factor (PAF) lipids, which are associated with CAD, have recently been linked with novel proposed etiopathological mechanisms for depression such as inflammation, oxidative/nitrosative stress, and vascular endothelial dysfunction. METHODS AND RESULTS This hypothesis-generating study investigated the relationships between various PAF species and depressive symptoms in 26 CAD patients (age: 60.6±9.2 years, 69% male, mean Hamilton Depression Rating Scale [HAM-D] score: 11.8±5.2, HAM-D range: 3-20). Plasma PAF analyses were performed using high performance liquid chromatography electrospray ionization mass spectrometry in precursor ion scan. Significant associations between depressive symptom severity (HAM-D score) and a greater plasma abundance of the PAFs phosphocholine (PC) PC(O-12:0/2:0) (r=0.49, P=0.01), PC(O-14:1/2:0) (r=0.43, P=0.03), PC(O-17:3/2:0) (r=0.44, P=0.04), and PC(O-18:3/2:0) (r=0.50, P=0.01) were observed. Associations between those PAFs and HAM-D score persisted after adjusting for age and sex. CONCLUSION These preliminary findings support the exploration of the PAF lipidome for depressive symptom biomarkers in CAD patients. Patients were recruited as part of the following clinical trial: NCT00981383.
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Affiliation(s)
- Graham Mazereeuw
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada ; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Nathan Herrmann
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada ; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Hongbin Xu
- Ottawa Institute of Systems Biology and Neural Regeneration Laboratory, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Alexandre P Blanchard
- Ottawa Institute of Systems Biology and Neural Regeneration Laboratory, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Daniel Figeys
- Ottawa Institute of Systems Biology and Neural Regeneration Laboratory, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Paul I Oh
- UHN Toronto Rehabilitation Institute, Toronto, ON, Canada
| | - Steffany Al Bennett
- Ottawa Institute of Systems Biology and Neural Regeneration Laboratory, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada
| | - Krista L Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Sunnybrook Health Sciences Centre, Toronto, ON, Canada ; Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada ; CIHR Training Program in Neurodegenerative Lipidomics, Department of Biochemistry, Microbiology, and Immunology, University of Ottawa, Ottawa, ON, Canada ; Department of Psychiatry, University of Toronto, Toronto, ON, Canada ; UHN Toronto Rehabilitation Institute, Toronto, ON, Canada
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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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Alevizos M, Karagkouni A, Panagiotidou S, Vasiadi M, Theoharides TC. Stress triggers coronary mast cells leading to cardiac events. Ann Allergy Asthma Immunol 2014; 112:309-16. [PMID: 24428962 PMCID: PMC4288814 DOI: 10.1016/j.anai.2013.09.017] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 08/30/2013] [Accepted: 09/17/2013] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Stress precipitates and worsens not only asthma and atopic dermatitis but also acute coronary syndromes (ACSs), which are associated with coronary inflammation. Evidence linking stress to ACS was reviewed and indicated that activation of coronary mast cells (MCs) by stress, through corticotropin-releasing hormone (CRH) and other neuropeptides, contributes to coronary inflammation and coronary artery disease. DATA SOURCES PubMed was searched (2005-2013) for articles using the following keywords: allergies, anaphylaxis, anxiety, coronary arteries, coronary artery disease, C-reactive protein, cytokines, chymase, histamine, hypersensitivity, interleukin-6 (IL-6), inflammation, mast cells, myocardial ischemia, niacin, platelet-activating factor, rupture, spasm, statins, stress, treatment, tryptase, and uroctortin. STUDY SELECTIONS Articles were selected based on their relevance to how stress affects ACS and how it activates coronary MCs, leading to coronary hypersensitivity, inflammation, and coronary artery disease. RESULTS Stress can precipitate allergies and ACS. Stress stimulates MCs through the activation of high-affinity surface receptors for CRH, leading to a CRH-dependent increase in serum IL-6. Moreover, neurotensin secreted with CRH from peripheral nerves augments the effect of CRH and stimulates cardiac MCs to release IL-6, which is elevated in ACS and is an independent risk factor for myocardial ischemia. MCs also secrete CRH and uroctortin, which induces IL-6 release from cardiomyocytes. The presence of atherosclerosis increases the risk of cardiac MC activation owing to the stimulatory effect of lipoproteins and adipocytokines. Conditions such as Kounis syndrome, mastocytosis, and myalgic encephalopathy/chronic fatigue syndrome are particularly prone to coronary hypersensitivity reactions. CONCLUSION Inhibition of cardiac MCs may be a novel treatment approach.
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Affiliation(s)
- Michail Alevizos
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; Present address: Department of Internal Medicine, Jacoby Medical Center, New York, New York
| | - Anna Karagkouni
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; Present address: Department of Psychiatry, Westchester Hospital, Mt Kisco, New York
| | - Smaro Panagiotidou
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Magdalini Vasiadi
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts
| | - Theoharis C Theoharides
- Molecular Immunopharmacology and Drug Discovery Laboratory, Department of Integrative Physiology and Pathobiology, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Internal Medicine, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Biochemistry, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts; Department of Psychiatry, Tufts University School of Medicine, Tufts Medical Center, Boston, Massachusetts.
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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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Feng LM, Feng GF, Chen Y. Evaluation of lipoprotein-associated phospholipase A2 in healthy Chinese Han adult serum. Lipids Health Dis 2014; 13:6. [PMID: 24393260 PMCID: PMC3895822 DOI: 10.1186/1476-511x-13-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 01/03/2014] [Indexed: 12/13/2022] Open
Abstract
Objective The aim of this study is to establish lipoprotein-associated phospholipase A2 (Lp-PLA2) reference intervals (RIs) in healthy Chinese Han adults as a clinical diagnostic indicator according to the Clinical and Laboratory Standards Institute (CLSI) C28-A3 guidelines. Design and methods Lp-PLA2 levels in 763 healthy Chinese Han subjects (392 males and 371 females) were determined by colorimetric analysis and the central 95th percentile RIs were determined using non-parametric statistical methods. The correlations between serum Lp-PLA2 and blood markers were analyzed by Spearman correlation analyses. Results The Lp-PLA2 levels showed a Gaussian distribution with a statistically significant difference between females and males (t = 4.866, P < 0.001). The RIs of serum Lp-PLA2 were 194–640 U/L (18–49 years) and 208–698 U/L (50–88 years) for females, and 230–728 U/L for males. There was a positive correlation between Lp-PLA2 levels and age, Body Mass Index (BMI), as well as with levels of alanine aminotransferase (ALT), gamma-glutamyltransferase (GGT), total bilirubin (TBIL), triglyceride (TG), total cholesterol (Tch), low density lipoprotein cholesterol (LDL-c), apolipoprotein B (apoB), glucose (Glu), high sensitivity C reactive protein (Hs-CRP), white blood cell (WBC), hemoglobin (HGB) and red blood cell (RBC) (P < 0.05). A negative correlation was found with high density lipoprotein cholesterol (HDL-c) and Apolipoprotein AI (apoAI), and no correlation was found with platelet (Plt) levels. Conclusion Our results establish the RIs of serum Lp-PLA2 in healthy Chinese Han adults and demonstrate correlations between serum Lp-PLA2 and age, BMI, ALT, GGT, TBIL, TG, Tch, HDL-c, LDL-c, apoAI, apoB, Glu, Hs-CRP, WBC, RBC, and HGB levels.
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Affiliation(s)
| | | | - Yu Chen
- Department of Laboratory Medicine, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou 310003, P,R, China.
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Tellis CC, Moutzouri E, Elisaf M, Wolfert RL, Tselepis AD. The elevation of apoB in hypercholesterolemic patients is primarily attributed to the relative increase of apoB/Lp-PLA₂. J Lipid Res 2013; 54:3394-402. [PMID: 24092915 DOI: 10.1194/jlr.m041806] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Lipoprotein-associated phospholipase A₂ (Lp-PLA₂) is a risk factor of cardiovascular disease. Plasma Lp-PLA₂ is mainly associated with apolipoprotein (apo)B-containing lipoproteins, primarily with low density lipoproteins (LDLs). Importantly, only a proportion of circulating lipoproteins contain Lp-PLA₂. We determined the plasma levels of Lp-PLA₂-bound apoB (apoB/Lp-PLA₂) in patients with primary hypercholesterolemia. The effect of simvastatin therapy was also addressed. The plasma apoB/Lp-PLA₂ concentration in 50 normolipidemic controls and 53 patients with primary hypercholesterolemia at baseline and at 3 months posttreatment with simvastatin (40 mg/day) was determined by an enzyme-linked immunosorbent assay. The concentration of the apoB-containing lipoproteins that do not bind Lp-PLA₂ [apoB/Lp-PLA₂⁻] was calculated by subtracting the apoB/Lp-PLA₂ from total apoB. The apoB/Lp-PLA₂ levels were 3.6-fold higher, while apoB/Lp-PLA₂⁻ were 1.3-fold higher in patients compared with controls. After 3 months of simvastatin treatment apoB/Lp-PLA₂ and apoB/Lp-PLA₂⁻ levels were reduced by 52% and 33%, respectively. The elevation in apoB-containing lipoproteins in hypercholesterolemic patients is mainly attributed to the relative increase in the proatherogenic apoB/Lp-PLA₂, while simvastatin reduces these particles to a higher extent compared with apoB/Lp-PLA₂⁻. Considering that Lp-PLA₂ is proatherogenic, the predominance of apoB/Lp-PLA₂ particles in hypercholesterolemic patients may contribute to their higher atherogenicity and incidence of cardiovascular disease.
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Affiliation(s)
- Constantinos C Tellis
- Laboratory of Biochemistry, Department of Chemistry University of Ioannina, Ioannina, Greece
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Lipoprotein-associated phospholipase A(2) bound on high-density lipoprotein is associated with lower risk for cardiac death in stable coronary artery disease patients: a 3-year follow-up. J Am Coll Cardiol 2012; 60:2053-60. [PMID: 23083783 DOI: 10.1016/j.jacc.2012.06.057] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2012] [Revised: 06/12/2012] [Accepted: 06/19/2012] [Indexed: 11/24/2022]
Abstract
OBJECTIVES The aim of this study was to examine the prognostic value of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) associated with high-density lipoprotein (HDL) (HDL-Lp-PLA(2)) in patients with stable coronary artery disease (CAD). BACKGROUND Lp-PLA(2) is a novel risk factor for cardiovascular disease. It has been postulated that the role of Lp-PLA(2) in atherosclerosis may depend on the type of lipoprotein with which it is associated. METHODS Total plasma Lp-PLA(2) and HDL-Lp-PLA(2) mass and activity, lipids, and C-reactive protein were measured in 524 consecutive patients with stable CAD who were followed for a median of 34 months. The primary endpoint was cardiac death, and the secondary endpoint was hospitalization for acute coronary syndromes, myocardial revascularization, arrhythmic event, or stroke. RESULTS Follow-up data were obtained from 477 patients. One hundred twenty-three patients (25.8%) presented with cardiovascular events (24 cardiac deaths, 47 acute coronary syndromes, 28 revascularizations, 22 arrhythmic events, and 2 strokes). Total plasma Lp-PLA(2) mass and activity were predictors of cardiac death (hazard ratio [HR]: 1.013; 95% confidence interval [CI]: 1.005 to 1.021; p = 0.002; and HR: 1.040; 95% CI: 1.005 to 1.076; p = 0.025, respectively) after adjustment for traditional risk factors for CAD. In contrast, HDL-Lp-PLA(2) mass and activity were associated with lower risk for cardiac death (HR: 0.972; 95% CI: 0.952 to 0.993; p = 0.010; and HR: 0.689; 95% CI: 0.496 to 0.957; p = 0.026, respectively) after adjustment for traditional risk factors for CAD. CONCLUSIONS Total plasma Lp-PLA(2) is a predictor of cardiac death, while HDL-Lp-PLA(2) is associated with lower risk for cardiac death in patients with stable CAD, independently of other traditional cardiovascular risk factors.
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Dohi T, Miyauchi K, Ohkawa R, Nakamura K, Thuboi S, Ogita M, Miyazaki T, Nishino A, Yokoyama K, Kurata T, Yatomi Y, Daida H. Higher lipoprotein-associated phospholipase A2 levels are associated with coronary atherosclerosis documented by coronary angiography. Ann Clin Biochem 2012; 49:527-33. [PMID: 22933444 DOI: 10.1258/acb.2012.011252] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been proposed as an inflammatory marker of cardiovascular disease. The present study investigates associations between Lp-PLA2 and other important biomarkers in Japanese patients with coronary artery disease. METHODS We measured Lp-PLA2 levels in 141 consecutive patients (age 62.6 ± 3.8 years; men 69.2%) with angiographic evidence of coronary artery disease (acute coronary syndrome [ACS]; n = 38), stable angina pectoris (SAP; n = 72) or with angiographically normal coronary arteries (NCA; n = 31). RESULTS Levels of Lp-PLA2 significantly correlated with low-density lipoprotein-cholesterol (r = 0.302), homocysteine (r = 0.528) and paraoxonase (r = 0.401) in all patients (all P < 0.01). Levels of Lp-PLA2 were significantly higher in patients with coronary atherosclerosis (ACS and SAP) than with NCA (P < 0.05). Levels of highly sensitive C-reactive protein were significantly higher in patients with ACS than with SAP and NCA (both P < 0.05). Multivariate logistic regression analyses revealed that higher Lp-PLA2 levels were independently associated with coronary atherosclerosis (odds ratio: 1.058; 95% confidence interval: 1.012-1.121; P = 0.001). CONCLUSIONS Higher Lp-PLA2 levels are associated with coronary atherosclerosis independently of traditional coronary risk factors. Thus, Lp-PLA2 is a novel biomarker of coronary atherosclerosis in Japanese patients.
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Affiliation(s)
- Tomotaka Dohi
- Department of Cardiovascular Medicine, Juntendo University School of Medicine, 2-1-1 Hongo, Tokyo 113-0033, Japan.
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Abstract
Although an atherogenic lipoprotein phenotype has been well recognized as an important predictor of cardiovascular disease, recent studies have demonstrated a number of additional lipid-related markers as emerging biomarkers to identify patients at risk for future coronary heart disease. Among them, lipoprotein-associated phospholipase A(2) (Lp-PLA(2)), seems to be a promising candidate that might be added to the clinical armamentarium for improved prediction of cardiovascular disease in the future. Of particular note, Lp-PLA(2) is the only enzyme that cleaves oxidized low-density lipoprotein (oxLDL) in the subendothelial space, with further generation of proinflammatory mediators such as lysophosphatidylcholine (LysoPC) and oxidized fatty acid (oxFA), thereby probably linking two important features of atherogenesis, namely oxidation of LDL and local inflammatory processes within the atherosclerotic plaque. This overview aims to summarize our current knowledge based on observations from recent experimental and clinical studies. Emphasis has been put on potential pathophysiological mechanisms of action and on the clinical relevance of Lp-PLA(2) in a wide variety of clinical settings, including apparently healthy individuals, patients with stable angina or acute coronary syndromes, after myocardial infarction, and with subclinical disease. Although a growing body of evidence from epidemiological and clinical studies suggests that Lp-PLA(2) may represent an independent and clinically relevant long-term risk marker for coronary heart disease and, probably, also for stroke, the role of this enzyme in the setting of the acute coronary syndrome remains to be established.
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Affiliation(s)
- Natalie Khuseyinova
- Department of Internal Medicine II - Cardiology, University of Ulm Medical Center, Ulm, Germany
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Winkler K, Hoffmann MM, Krane V, Drechsler C, Wanner C. Lipoprotein-associated phospholipase A2 and outcome in patients with type 2 diabetes on haemodialysis. Eur J Clin Invest 2012; 42:693-701. [PMID: 22211481 DOI: 10.1111/j.1365-2362.2011.02634.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Lipoprotein-associated phospholipase A2 (LpPLA2) is a lipoprotein-bound enzyme involved in inflammation and atherosclerosis. In a post hoc analysis of a controlled trial with atorvastatin in patients with type 2 diabetes (T2D) on haemodialysis, we examined the association between baseline and change by measuring baseline LpPLA2 activity on cardiovascular events (CVE) and mortality. METHODS AND RESULTS LpPLA2 activity was available of 1202 patients at baseline and 6 months after randomisation from 1255 patients in the German Diabetes Dialysis Study. During the 4-year follow-up, 445 patients (37%) suffered from CVE and 583 patients (49%) died. The highest quartile of LpPLA2 activity (≥615 U/L) was associated with elevated risk for CVE [HR 1·35 (1·02-1·87); P = 0·035]. This association was mainly driven by the placebo group [HR 1·51 (1·01-2·25); P = 0·046]. Receiver-operating characteristics analysis revealed that including LpPLA2 activity in an already adjusted model increased the area under the curve (AUC) for CVE from 0·586 (0·553-0·620) to 0·632 (0·599-0·664; P = 0·020) and for death from 0·704 (0·674-0·733) to 0·708 (0·679-0·737; P = 0·026). In atorvastatin-treated patients, the decrease in LpPLA2 was associated with reduced fatal risk [HR per standard deviation 0·74 (0·62-0·90); P = 0·002], an effect not seen in the placebo group. In contrast, those patients in the placebo group presenting a > 25% decrease in LpPLA2 activity (n = 33) had a more than doubled risk of dying [HR 2·48 (1·56-3·95); P < 0·001]. CONCLUSION LpPLA2 activity is predictive for cardiovascular outcome and total mortality. Reducing LpPLA2 by atorvastatin was associated with reduced mortality in patients with T2D on haemodialysis.
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Affiliation(s)
- Karl Winkler
- Department of Clinical Chemistry, University Medical Center Freiburg, Hugstetter Strasse 55, Freiburg, Germany.
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Nelson TL, Biggs ML, Kizer JR, Cushman M, Hokanson JE, Furberg CD, Mukamal KJ. Lipoprotein-associated phospholipase A2 (Lp-PLA2) and future risk of type 2 diabetes: results from the Cardiovascular Health Study. J Clin Endocrinol Metab 2012; 97:1695-701. [PMID: 22399516 PMCID: PMC3339885 DOI: 10.1210/jc.2011-3026] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Lipoprotein-associated phospholipase A2 (Lp-PLA(2)) has been consistently associated with cardiovascular disease (CVD) risk factors and predictive of CVD outcomes; furthermore, it is consistently higher among type 2 diabetics than nondiabetics. However, the relationships of circulating Lp-PLA(2) mass and activity with incident type 2 diabetes mellitus have not been examined. Therefore, the purpose of this study was to determine the association of Lp-PLA(2) mass and activity with type 2 diabetes among older adults. METHODS We conducted analyses of Lp-PLA(2) and prevalent and incident diabetes among 5474 men and women from the Cardiovascular Health Study (1989-2007). Lp-PLA(2) mass and activity were measured in baseline plasma. Diabetes status was ascertained annually with medication inventories and repeated blood glucose measurements. Generalized linear and Cox proportional hazards models were used to adjust for confounding factors including body mass index and inflammation. RESULTS At baseline, the top two quintiles of Lp-PLA(2) activity were significantly associated with prevalent type 2 diabetes with a multivariable relative risk = 1.35 [95% confidence interval (CI) = 1.11-1.63] for quintile 4, and relative risk = 1.33 (95% CI = 1.07-1.66) for quintile 5. Among participants free of diabetes at baseline, we found a significant positive association with both the homeostatic model assessment for insulin resistance and β-cell function per SD increase in Lp-PLA(2) activity (P values for both <0.01). In prospective analyses, the risk of incident type 2 diabetes was significantly higher among those in the highest quintile of Lp-PLA(2) activity [multivariable hazard ratio = 1.45 (95% CI = 1.01-2.07)] compared with the lowest quintile. Lp-PLA(2) mass was not significantly associated with incident type 2 diabetes. DISCUSSION Lp-PLA(2) activity is positively associated with insulin resistance and predicts incident type 2 diabetes among older adults independent of multiple factors associated with diabetes pathogenesis.
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Affiliation(s)
- T L Nelson
- Colorado State University, Colorado School of Public Health and Department of Health and Exercise Science, 220 Moby Complex, Fort Collins, Colorado 80523-1582, USA.
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Vittos O, Toana B, Vittos A, Moldoveanu E. Lipoprotein-associated phospholipase A2 (Lp-PLA2): a review of its role and significance as a cardiovascular biomarker. Biomarkers 2012; 17:289-302. [PMID: 22401038 DOI: 10.3109/1354750x.2012.664170] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
OBJECTIVE To conduct a comprehensive, systematic review of studies assessing the significance of lipoprotein-associated phospholipase A2 in cardiovascular diseases (CVDs). MATERIAL AND METHODS A review of the literature was performed using the search term "Lipoprotein-associated phospholipase A2 (Lp-PLA2)" and each of the following terms: "cardiovascular risk," "cardiovascular death," "atherosclerotic disease," "coronary events," "transient ischemic attack (TIA)," "stroke," and "heart failure." The searches were performed on Medline, Google Scholar and ClinicalTrials.gov. RESULTS The majority of published studies showed a significant association between Lp-PLA2 levels and cardiovascular events after multivariate adjustment. The association was consistent across a wide variety of subjects of both sexes and different ethnic backgrounds. CONCLUSIONS The role of Lp-PLA2 as a significant biomarker of vascular inflammation was confirmed, and Lp-PLA2 seems to be closely correlated to cardiovascular events. It may be an important therapeutic target and may have an important role in prevention, risk stratification and personalised medicine.
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Paik JK, Kim JY, Kim OY, Lee Y, Jeong TS, Sweeney G, Jang Y, Lee JH. Circulating and PBMC Lp-PLA2 associate differently with oxidative stress and subclinical inflammation in nonobese women (menopausal status). PLoS One 2012; 7:e29675. [PMID: 22359537 PMCID: PMC3281008 DOI: 10.1371/journal.pone.0029675] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2011] [Accepted: 12/02/2011] [Indexed: 01/17/2023] Open
Abstract
BACKGROUND This study aimed to determine the association of lipoprotein-associated phospholipase A(2) (Lp-PLA(2)) activity in circulation and peripheral blood mononuclear cells (PBMCs) with inflammatory and oxidative stress markers in nonobese women and according to menopausal status. Lp-PLA(2) activity, a marker for cardiovascular risk is associated with inflammation and oxidative stress. METHODOLOGY/PRINCIPAL FINDINGS Eighty postmenopausal women (53.0±4.05 yr) and 96 premenopausal women (39.7±9.25 yr) participated in this study. Lp-PLA(2) activities, interleukin (IL)-6, tumor necrosis factor (TNF)-α, and IL-1β in plasma as well as in PBMCs were measured. Plasma ox-LDL was also measured. Postmenopausal women demonstrated higher circulating levels of ox-LDL and IL-6, as well as IL-6, TNF-α, and IL-1β in PBMCs, than premenopausal women. In both groups, plasma Lp-PLA(2) activity positively correlated with Lp-PLA(2) activity in PBMCs and plasma ox-LDL. In premenopausal women, Lp-PLA(2) activities in plasma and PBMCs positively correlated with IL-6, TNF-α, and IL-1β in PBMCs. In postmenopausal women, plasma ox-LDL positively correlated with PBMC cytokine production. In subgroup analysis of postmenopausal women according to plasma ox-LDL level (median level: 48.715 U/L), a significant increase in Lp-PLA(2) activity in the plasma but not the PBMCs was found in the high ox-LDL subgroup. Plasma Lp-PLA(2) activity positively correlated with unstimulated PBMC Lp-PLA(2) activity in the low ox-LDL subgroup (r = 0.627, P<0.001), whereas in the high ox-LDL circulating Lp-PLA(2) activity positively correlated with plasma ox-LDL (r = 0.390, P = 0.014) but not with Lp-PLA(2) activity in PBMCs. CONCLUSIONS/SIGNIFICANCE The lack of relation between circulating Lp-PLA(2) activity and Lp-PLA(2) activity in PBMCs was found in postmenopausal women with high ox-LDL. This may indicate other sources of circulating Lp-PLA(2) activity except PBMC in postmenopausal women with high ox-LDL. We also demonstrated that circulating Lp-PLA(2) and PBMC secreted Lp-PLA(2) associate differently with markers of oxidative stress and sub clinical inflammation in nonobese women, particularly according to the menopausal states.
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Affiliation(s)
- Jean Kyung Paik
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Ji Young Kim
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Oh Yoen Kim
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Yonghee Lee
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
| | - Tae-Sook Jeong
- National Research Laboratory of Lipid Metabolism and Atherosclerosis, Korea Research Institute of Bioscience and Biotechnology, Daejeon, Korea
| | - Gary Sweeney
- Institut Pasteur Korea, Seoul, Korea & Department of Biology, York University, Toronto, Canada
| | - Yangsoo Jang
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- Cardiology Division, Yonsei University College of Medicine, Seoul, Korea
- Cardiovascular Genome Center, Yonsei University College of Medicine, Seoul, Korea
- Severance Medical Research Institute, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Ho Lee
- Yonsei University Research Institute of Science for Aging, Yonsei University, Seoul, Korea
- National Research Laboratory of Clinical Nutrigenetics/Nutrigenomics, Department of Food and Nutrition, College of Human Ecology, Yonsei University, Seoul, Korea
- * E-mail:
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Sternberg Z, Drake A, Sternberg DS, Benedict RHB, Li F, Hojnacki D, Weinstock-Guttmann B, Munschauer FE. Lp-PLA2: Inflammatory Biomarker of Vascular Risk in Multiple Sclerosis. J Clin Immunol 2012; 32:497-504. [DOI: 10.1007/s10875-011-9642-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2011] [Accepted: 12/22/2011] [Indexed: 10/14/2022]
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Xiao Q, Pepe AE, Wang G, Luo Z, Zhang L, Zeng L, Zhang Z, Hu Y, Ye S, Xu Q. Nrf3-Pla2g7 interaction plays an essential role in smooth muscle differentiation from stem cells. Arterioscler Thromb Vasc Biol 2012; 32:730-44. [PMID: 22247257 DOI: 10.1161/atvbaha.111.243188] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Phospholipase A2, group 7 (Pla2g7) is an important mediator in cardiovascular development and diseases because of its divergent physiological and pathological functions in inflammation and oxidative stress. However, little is known about the functional role of Pla2g7 in smooth muscle cell (SMC) differentiation from stem cells. METHODS AND RESULTS In the present study, embryonic stem cells were cultivated on collagen IV-coated plates to allow SMC differentiation. Pla2g7 gene expression and activity were upregulated significantly following 4 to 14 days of cell differentiation and colocalized with SMC differentiation markers in the differentiated SMCs. Knockdown of Pla2g7 resulted in downregulation of smooth muscle-specific markers in vitro and impairment of SMC differentiation in vivo, whereas enforced expression of Pla2g7 enhanced SMC differentiation and increased reactive oxygen species generation. Importantly, enforced expression of Pla2g7 significantly increased the binding of serum response factor to SMC differentiation gene promoters, resulting in SMC differentiation, which was abolished by free radical scavenger and flavoprotein inhibitor of NADPH oxidase but not hydrogen peroxide inhibitor. Moreover, we demonstrated that nuclear factor erythroid 2-related factor 3 (Nrf3) regulates Pla2g7 gene expression through direct binding to the promoter regions of Pla2g7 gene. CONCLUSION Our findings demonstrated that Pla2g7 plays a crucial physiological role in SMC differentiation from stem cells, and the fine interactions between Nrf3 and Pla2g7 are essential for SMC differentiation.
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Affiliation(s)
- Qingzhong Xiao
- Centre for Clinical Pharmacology, William Harvey Research Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, United Kingdom.
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Mishra M, Kumar H, Bajpai S, Singh RK, Tripathi K. Level of serum IL-12 and its correlation with endothelial dysfunction, insulin resistance, proinflammatory cytokines and lipid profile in newly diagnosed type 2 diabetes. Diabetes Res Clin Pract 2011; 94:255-61. [PMID: 21855158 DOI: 10.1016/j.diabres.2011.07.037] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2011] [Revised: 07/20/2011] [Accepted: 07/25/2011] [Indexed: 02/07/2023]
Abstract
AIM This study was an attempt to evaluate and correlate serum interleukin-12 (IL-12) with different circulating markers in newly diagnosed type-2 diabetes mellitus (T2DM) for possible progression of atherosclerosis. METHODS For this study, we recruited 1968 family members of diabetics and 349 had abnormal glucose. Out of 349 subjects, 197 were T2DM as per American Diabetes Association guidelines and further investigated for cardiovascular abnormalities. 63 T2DM have high sensitive C-reactive protein (hsCRP)>3.0mg/l and cardiovascular complications. Overall, 150 subjects, 50 healthy, 50 T2DM (D1) and 50 T2DM with cardiovascular complications (D2) were enrolled and investigated for soluble markers. RESULTS The levels of serum glucose, proinflammatory cytokines (IL-6, IL-12, tumor necrosis factor), endothelial dysfunction markers [vascular cell adhesion molecule-1 (VCAM-1), inter-cellular adhesion molecule-1 (ICAM-1), nitric oxide] and lipid abnormality were highest in D2 group. Correlation and regression study showed that IL-12 was dependent on hsCRP, insulin resistance, VCAM-1, ICAM-1 and lipids. The multivariate stepwise regression analysis demonstrates that hsCRP contributes significantly for variance of IL-12. CONCLUSION This study reveals that, even first-time diagnosis of T2DM, subjects with higher insulin resistance and abnormal lipids have elevated IL-12, endothelial dysfunction and proinflammatory markers. Further increased hsCRP enhance IL-12 which up-regulate cardiovascular disease progression.
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Affiliation(s)
- Manish Mishra
- Department of Medicine, Institute of Medical Sciences, Banaras Hindu University, Varanasi 221005, India
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Liu J, Hong Y, Qi Y, Zhao F, Zhao D. Systematic Review of the Association between Lipoprotein-Associated Phospholipase A2 and Atherosclerosis. NORTH AMERICAN JOURNAL OF MEDICINE & SCIENCE 2011; 4:201-211. [PMID: 26339459 PMCID: PMC4555875 DOI: 10.7156/v4i4p201] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is a novel inflammatory biomarker. Basic research has shown that Lp-PLA2 is involved in the pathogenesis of atherosclerosis. In the past decade, an increasing number of epidemiological studies have investigated the association of Lp-PLA2 with atherosclerosis, but its roles in the different stages of atherosclerosis are not established. By undertaking a systematic review of the epidemiological studies on the relationship between Lp-PLA2 and atherosclerotic cardiovascular disease (CVD)/subclinical atherosclerosis, we tried to evaluate the relationship between Lp-PLA2 and the different stages of atherosclerosis. MEDLINE, Cochrane Library, and National Knowledge Infrastructure (CNKI) were searched up to September 1st, 2011. The references in all the located articles were manually searched. Epidemiological studies on the association of Lp-PLA2 with CVD and subclinical atherosclerosis, with total CVD, coronary heart disease (CHD), stroke, and subclinical atherosclerosis as their observation endpoints or outcome variables, were included in this study. Studies which did not assess the hazard ratio (HR), relative risk (RR), or odds ratio (OR) of Lp-PLA2 or which did not adjust for other known risk factors were excluded. The general information, study design, sample size, outcome variables and their definitions, follow-up duration, Lp-PLA2 measurements, variables adjusted in the multivariate analysis and main results in the literatures were retrieved. Thirty-nine studies were enrolled in this systematic review. Thirty-three studies (49, 260 subjects) investigated the relationship between Lp-PLA2 and CVD, among which 31 showed that increased Lp-PLA2 is associated to high risk for incidence or mortality of CVD: HR/RR per 1 standard deviation (SD) increase = 1.17-1.40; RR for the highest as compared with the lowest quartile was 1.41-3.75 (1.8-2.5 in most studies). Six studies (four cross-sectional studies and two case-control studies, with an overall sample size of 5,537) explored the relationship between Lp-PLA2 and subclinical atherosclerosis; among them, two studies demonstrated that Lp-PLA2 was associated with coronary artery calcification in young adults and men. In conclusion, many epidemiological studies have demonstrated that Lp-PLA2 increases the risk of clinical CVD events. However, whether there is a similar association between Lp-PLA2 and subclinical atherosclerosis remains unclear. Whether Lp-PLA2 exerts its effect during the occurrence of clinical events promoted by unstable plaques or at the early stage of atherosclerosis needs to be clarified in further prospective studies.
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Affiliation(s)
- Jing Liu
- Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Yuling Hong
- Division for Heart Disease & Stroke Prevention, Center for Disease Control and Prevention, Atlanta, Georgia
| | - Yue Qi
- Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Fan Zhao
- Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Dong Zhao
- Beijing An Zhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
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Mangalmurti SS, Davidson MH. The Incremental Value of Lipids and Inflammatory Biomarkers in Determining Residual Cardiovascular Risk. Curr Atheroscler Rep 2011; 13:373-80. [DOI: 10.1007/s11883-011-0190-3] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Garg PK, McClelland RL, Jenny NS, Criqui M, Liu K, Polak JF, Jorgensen NW, Cushman M. Association of lipoprotein-associated phospholipase A2 and endothelial function in the Multi-Ethnic Study of Atherosclerosis (MESA). Vasc Med 2011; 16:247-52. [DOI: 10.1177/1358863x11411360] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Mechanisms underlying the role of lipoprotein-associated phospholipase A2 (Lp-PLA2) in atherosclerotic development are not completely understood. We evaluated the relationship of Lp-PLA2 with endothelial dysfunction, an early manifestation of atherosclerosis, in a cohort without known clinical cardiovascular disease. A total of 2809 participants in the Multi-Ethnic Study of Atherosclerosis underwent plasma Lp-PLA2 mass and activity measurement and brachial artery flow-mediated vasodilation testing. In adjusted linear regression models, higher Lp-PLA2 mass and activity levels were not associated with lower endothelial function (−0.04%, p = 0.51 and −0.09%, p = 0.10, respectively). Among individuals with subclinical atherosclerosis based on ankle–brachial index (ABI) or carotid intima–media thickness (IMT), Lp-PLA2 mass and activity were not associated with lower endothelial function (−0.03%, p = 0.88 and −0.31%, p = 0.16 for ABI < 1.00; 0.01%, p = 0.94 and −0.15%, p = 0.20 for abnormal carotid IMT). In summary, Lp-PLA2 is not associated with endothelial dysfunction, suggesting its role in atherosclerosis development is primarily related to other factors.
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Affiliation(s)
- Parveen K Garg
- Division of Cardiology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Nancy S Jenny
- Department of Pathology, University of Vermont College of Medicine, Burlington, VT, USA
| | - Michael Criqui
- Department of Preventive Medicine, University of California in San Diego School of Medicine, San Diego, CA, USA
| | - Kiang Liu
- Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Joseph F Polak
- Department of Radiology, Tufts Medical Center, Boston, MA, USA
| | - Neal W Jorgensen
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Mary Cushman
- Department of Pathology, 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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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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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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Nelson TL, Hokanson JE, Hickey MS. Omega-3 fatty acids and lipoprotein associated phospholipase A(2) in healthy older adult males and females. Eur J Nutr 2010; 50:185-93. [PMID: 20706728 DOI: 10.1007/s00394-010-0126-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2010] [Accepted: 07/29/2010] [Indexed: 11/25/2022]
Abstract
PURPOSE Lipoprotein associated phospholipase A(2) (Lp-PLA(2)) is a novel inflammatory factor that has been independently associated with stroke and cardiovascular disease (CVD). Omega-3 fats have been implicated in reducing inflammation associated with CVD. The aim of this study was to determine if an 8-week isocaloric diet supplemented with eicosapentaenoic acid (EPA) and docosahexaenoic (DHA) in the form of fish oil or α-linolenic acid (ALA) in the form of flaxseed oil would alter Lp-PLA(2) among healthy adults ages 50 years and older. METHODS Fifty-nine healthy adults (~75% female, average age 61 years) were randomized to one of three groups with equal amounts of total fat intake. All capsules contained ~1 g of fat. The control group (n = 19) consumed olive oil capsules (~11 g/day); the ALA group (n = 20) consumed flaxseed oil capsules (~11 g/day) and the EPA/DHA group (n = 20) consumed fish oil capsules (~2 g/day + 9 g/day of olive oil). Fasting blood samples were obtained before and after the 8-week intervention for determination of Lp-PLA(2) mass and activity as well as lipid values. RESULTS We did not find any significant changes in Lp-PLA(2) mass or activity after the intervention in any of the groups; however, change in oxidized LDL was associated with change in Lp-PLA(2) mass (r = 0.37, p < 0.01). CONCLUSION Supplementing the diet with omega-3 fatty acids for 8-weeks did not influence Lp-PLA(2) activity or mass among older adults; altering oxidized LDL may be necessary to see changes in Lp-PLA(2) levels.
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Affiliation(s)
- T L Nelson
- Human Performance Clinical/Research Laboratory, Department of Health and Exercise Science, Colorado State University, Fort Collins, CO 80523, USA.
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Abstract
Lipoprotein-associated phospholipase A2 is an enzyme produced by inflammatory cells, which binds to apolipoprotein B-containing lipoproteins and degrades oxidatively modified phospholipids in low-density lipoprotein cholesterol particles, leading to formation of proinflammatory and cytotoxic products. Experimental studies suggest a role for lipoprotein-associated phospholipase A2 in the formation of advanced rupture-prone atherosclerotic lesions, and epidemiological investigations have linked it to increased cardiovascular risk. Ongoing trials are evaluating the role of novel pharmacological inhibitors of this enzyme, such as darapladib, in the management of high-risk coronary artery disease patients.
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Affiliation(s)
- Eva Lonn
- Hamilton Health Sciences and Population Health Research Institute, McMaster University, Hamilton, Ontario, Canada.
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Miller RG, Costacou T, Orchard TJ. Lipoprotein-associated phospholipase A2, C-reactive protein, and coronary artery disease in individuals with type 1 diabetes and macroalbuminuria. Diab Vasc Dis Res 2010; 7:47-55. [PMID: 20368232 PMCID: PMC2858394 DOI: 10.1177/1479164109346358] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Given the paucity of data in type 1 diabetes concerning lipoprotein-associated phospholipase A( 2) (Lp-PLA(2)), we examined its prospective relationship with coronary artery disease (CAD), as well as the effect of modification by C-reactive protein (CRP) and haptoglobin genotype, in individuals with type 1 diabetes who are at an increased risk for CAD due to also having macroalbuminuria (n=96). Although Lp-PLA(2) activity was univariately predictive of CAD (HR=1.54 per SD, p=0.009), this relationship was not significant after covariate adjustment (p=0.59). There was a significant interaction between Lp-PLA(2) and CRP (p=0.02), i.e. those with both markers greater than the median level were more likely to have a CAD event than those persons with low levels of both (HR=2.89, p=0.06). When stratified by haptoglobin genotype, Lp-PLA(2) was predictive of CAD in persons with the 2/1 (HR=2.40, p=0.05), but not 2/2 (HR=0.66, p=0.27), genotype. The association between Lp-PLA(2) activity and CAD differs by CRP and haptoglobin genotype in this group of persons with type 1 diabetes and macroalbuminuria.
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Affiliation(s)
- Rachel G. Miller
- University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health, 3512 Fifth Avenue, Pittsburgh, PA 15213
| | - Tina Costacou
- University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health, 3512 Fifth Avenue, Pittsburgh, PA 15213
| | - Trevor J. Orchard
- University of Pittsburgh, Department of Epidemiology, Graduate School of Public Health, 3512 Fifth Avenue, Pittsburgh, PA 15213
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Contemporary scientific insights: role of biomarkers of inflammation in cardiovascular disease/atherosclerosis. Crit Pathw Cardiol 2009; 5:191-210. [PMID: 18340237 DOI: 10.1097/01.hpc.0000248966.42773.ca] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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OxLDL stimulates lipoprotein-associated phospholipase A2 expression in THP-1 monocytes via PI3K and p38 MAPK pathways. Cardiovasc Res 2009; 85:845-52. [DOI: 10.1093/cvr/cvp367] [Citation(s) in RCA: 55] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
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