Lipoprotein-Associated Phospholipase A 2
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CARDIOVASCULAR DISORDERS
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Lipoprotein-Associated Phospholipase A2 Review of its Role as a Marker and a Potential Participant in Coronary Endothelial Dysfunction Shahar Lavi,1 Ronit Lavi,2 Joseph P. McConnell,3 Lilach O. Lerman2 and Amir Lerman1 1 2 3
Division of Cardiovascular Diseases, Mayo Clinic, Rochester, Minnesota, USA Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota, USA Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota, USA
Contents Abstract . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 219 1. Inflammation and Vascular Endothelial Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220 2. Lipoprotein-Associated Phospholipase A2 (Lp-PLA2) as a Marker in Cardiovascular Disease . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 220 3. Lp-PLA2 and Vascular Endothelial Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 221 4. Postulated Role of Lp-PLA2 in the Mechanisms of Endothelial Dysfunction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 222 5. Clinical Perspectives . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 5.1 Measuring Lp-PLA2 . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 5.2 Lp-PLA2 as a Therapeutic Target . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 223 6. Conclusion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 224
Abstract
The role of inflammation in atherosclerosis continues to emerge. Lipoprotein-associated phospholipase A2 (Lp-PLA2), a novel plasma biomarker, circulates in the blood bound mainly to low-density lipoprotein (LDL) and promotes vascular inflammation. Several epidemiological studies have shown that circulating levels of LpPLA2 are an independent risk factor for cardiovascular events. Recent studies demonstrate that Lp-PLA2 is also associated with endothelial dysfunction and early atherosclerosis. This review provides an overview of these studies, suggests plausible mechanisms for the association between endothelial dysfunction and Lp-PLA2, and highlights future p
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