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DSI Newsletters, Issue 64:
Lp-PLA2 (Lipoprotein-associated PhosphoLipase 2)
Lipoprotein-associated phospholipase (Lp-PLA2
Lp-PLA2: An Inflammatory Biomarker
Increasing evidence has suggested that cardiovascular and other metabolic diseases are inflammatory diseases. The enzyme Lp-PLA2 (Lipoprotein-associated PhosphoLipase) circulates in the blood, and attaches to LDL cholesterol particles in the bloodstream. Sometimes these particles containing the Lp-PLA2 adhere to the arterial walls, where a process known as oxidation takes place. Oxidized LDL is susceptible to enzymatic attack, which promotes pro-inflammatory markers capable of triggering the atherogenic process. These inflammatory molecules help promote the build-up of fatty deposits (plaque) in the arteries, as well as produce molecules that attract immune cells to the arterial walls. These molecules bind to the cells called monocytes, which are large white blood cells, and are converted to macrophages, increasing the amount of atherosclerotic build-up attaching itself to the walls of the arteries thus creating the fatty plaque associated with hardening of the arteries.
Recent studies show that inflammation does play a role in cardiovascular disease (Castelli, et al., 1996; Libby, Ridker, & Maseri, 2002; Ridker, et al., 2000). It has been found that many persons with cardiovascular disease do not display traditional risk factors such as elevated cholesterol levels (Castelli, et al, 1996; Ridker, et al, 2000). Lp-PLA2 is considered currently considered a risk marker rather than a risk factor. However, the use of Lp-PLA2 in determining elevated risks for cardiovascular disease is relatively new. Two clinical studies have found that Lp-PLA2 to be independently linked to cardiovascular disease (Ballantyne, et al., 2003; Packard, et al., 2000). Several studies are underway regarding the importance of Lp-PLA2 as an inflammatory marker. However, very little is currently known regarding what role Lp-PLA2 plays in determining cardiovascular disease and what course of action is appropriate to improve Lp-PLA2 levels. Several studies have demonstrated the importance of CRP in the development of cardiovascular disease. More recently, the Lp-PLA2 has been linked to the atherogenic process. Two studies specifically have shown an associated between Lp-PLA2 with the development of cardiovascular disease (Both of these studies focused on Lp-PLA2 levels and found that those with elevated levels of Lp-PLA2 were at greater risk of an event compared to those with lower levels of Lp-PLA2 independent of traditional cardiovascular risk factors. Additionally, they found that Lp-PLA2 was individually and independently predictive of future cardiovascular events (Ballantyne, et al., 2003; Packard, et al., 2000).
Sincerely:
Joseph Saponaro, MD, DABIM, FACP, CPI, CCI, CCTI, CCRC, CCRP
PI (Principal Investigator), DSI (Drug Study Institute)
Board Certified Internist, JPMC (Jupiter Preventive Medicine Center)
DABIM (Diplomat American Board of Internal Medicine)
FACP (Fellow American College of Physicians)
CPI (Certified Physician Investigator) by the AAPP (American Academy of Pharmaceutical Physicians)
CCTI (Certified Clinical Trial Investigator) by the ACRP (Association of Clinical Research Professionals)
CCI (Certified Clinical Investigator) by the DIA (Drug Information Association)
CCRC (Certified Clinical Research Coordinator) by the ACRP (Association of Clinical Research Professionals)
CCRP (Certified Clinical Research Professional) by SoCRA (Society of Clinical Research Associates)
Member, SIMPD (Society for Innovative Medical Practice Design)
Member, ACPM (American College Preventive Medicine)
Ethics Committee Member, Jupiter Medical Center
IRB Member, Jupiter Medical Center
Founder, CertifiedResearchers.com