title: Lipoprotein-associated phospholipase A2: how effective as a risk marker of cardiovascular disease and as a therapeutic target?
abstract: Lipoprotein-associated phospholipase A2 (Lp-PLA2) has been studied extensively in terms of biology, pathophysiology, diagnostic and prognostic values. Lp-PLA2 is an enzyme produced in atherosclerotic plaque by inflammatory cells, linked to LDL, HDL and VLDL. The binding of Lp-PLA2 to a specific lipoprotein fraction renders it more atherogenic. Increasing evidence has demonstrated Lp-PLA2 as a novel "ideal" marker for CVD as of its high specificity for vascular inflammation and low biologic variability. Thus, determination of Lp-PLA2 in individuals may provide clinically relevant information about their future risk of CVD events. In addition, Lp-PLA2 has been considered as a therapeutic target, which has been acted upon indirectly (lipid lowering medications) and directly (Lp-PLA2 antagonists such as darapladib) in pharmacologic therapies. This review will provide an overview on biochemistry, biology, proatherogenic, proinflammatory and proapoptotic effects of Lp-PLA2. Clinical utility and its validity as an independent CVD biomarker as well as a diagnostic biomarker to be detected in the very early stages of atherosclerosis will be also discussed. Moreover, the role of Lp-PLA2 as a pharmacologic therapeutic target is another theme of this review.
authors.affiliation: Department of Pathology and Laboratory Medicine, Royal University Hospital, University of Saskatchewan, 103 Hospital Drive, Saskatoon S7N 0W8, Canada.
authors.forename: M S
authors.initials: MS
authors.lastname: Ahmed
authors.forename: Jing Zhang
authors.initials: JZ
authors.lastname: Ji
authors.forename: Qing H
authors.initials: QH
authors.lastname: Meng
mesh_terms: D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase / Q000737:chemistry / Q000378:metabolism / Q000502:physiology*; D000818:Animals; D050197:Atherosclerosis / Q000201:enzymology / Q000503:physiopathology; D015415:Biomarkers / Q000378:metabolism; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000201:enzymology / Q000453:epidemiology; D002986:Clinical Trials as Topic; D006801:Humans; D023421:Models, Animal; D058990:Molecular Targeted Therapy; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D043203:1-Alkyl-2-acetylglycerophosphocholine Esterase