title: Optimal therapy for reduction of lipoprotein(a).
abstract: OBJECTIVE
  There is a growing body of experimental and clinical evidence for the atherogenic and pro-thrombotic potential of Lipoprotein(a) [Lp(a)], as well as for its causative role in coronary heart disease and stroke. We comment on novel strategies for reducing Lp(a) levels.
  
  
  CONCLUSIONS
  Irrespective of the underlying biological mechanisms explaining the athero-thrombotic potential of this lipoprotein, most work has focused on the identification of suitable therapies for hyperlipoproteinemia(a). These include apheresis techniques, nicotinic acid and statins. None of these strategies have been shown to be definitely effective or convenient for the patient and new strategies are being attempted. Promising results are emerging with therapeutic interventions targeting the 'inflammatory pathways' by inhibition of Interleukin-6 (IL-6) signalling with natural compounds (e.g., Ginko biloba) or the IL-6 receptor antibody Tocilizumab. These may both lower Lp(a) and cardiovascular risk of the patients. Besides inhibiting platelet function, antiplatelet therapy with aspirin may also decrease the plasma concentration of Lp(a) and modulate its influence on platelets.
  
  
  CONCLUSIONS
  We highlight the inadequacy of current approaches for lowering Lp(a) and draw attention to novel insights that may lead to better treatment.
authors.affiliation: U.O. Diagnostica Ematochimica, Dipartimento di Patologia e Medicina di Laboratorio, Azienda Ospedaliero-Universitaria di Parma, Parma, Italy. glippi@ao.pr.it
authors.forename: G
authors.initials: G
authors.lastname: Lippi
authors.forename: G
authors.initials: G
authors.lastname: Targher
mesh_terms: D050197:Atherosclerosis / Q000209:etiology / Q000517:prevention & control; D003327:Coronary Disease / Q000209:etiology / Q000517:prevention & control; D016503:Drug Delivery Systems; D015195:Drug Design; D006801:Humans; D006951:Hyperlipoproteinemias / Q000150:complications / Q000188:drug therapy*; D017270:Lipoprotein(a) / Q000097:blood*; D020521:Stroke / Q000209:etiology / Q000517:prevention & control; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control
chemical_list: D017270:Lipoprotein(a)