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Lipoprotein(a) and inflammation- pathophysiological links and clinical implications for cardiovascular disease

Published:October 19, 2022DOI:https://doi.org/10.1016/j.jacl.2022.10.004

      Highlights

      • Lipoprotein(a) exerts pro-inflammatory effects on endothelial cells, monocytes and macrophages.
      • Oxidized phospholipids bound to apolipoprotein(a) drive Lp(a)-induced inflammation.
      • Lipoprotein(a) levels are influenced by inflammatory stimuli.
      • Lipoprotein(a) levels are influenced by anti-inflammatory treatment.
      • Pharmacological Lp(a) decrease may lead to partial decrease in inflammatory burden.

      Abstract

      The role of lipoprotein(a) (Lp[a]) as a significant and possibly causal cardiovascular disease (CVD) risk factor has been well established. Many studies, mostly experimental, have supported inflammation as a mediator of Lp(a)-induced increase in CVD risk. Lp(a), mainly through oxidized phospholipids bound to its apolipoprotein(a) part, leads to monocyte activation and endothelial dysfunction. The relationship between Lp(a) and inflammation is bidirectional as Lp(a) levels, besides being associated with inflammatory properties, are regulated by inflammatory stimuli or anti-inflammatory treatment. Reduction of Lp(a) concentration, especially by potent siRNA agents, contributes to partial reversion of the Lp(a) related inflammatory profile. This review aims to present the current pathophysiological and clinical evidence of the relationship between Lp(a) and inflammation.

      Keywords

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