| Popis: |
Since its discovery in 1963, our understanding of lipoprotein(a) [Lp(a)] has evolved from an antigenic component to a highly heritable biological trait with a risk factor role in atherosclerotic cardiovascular disease (CVD). However, much still needs to be done in understanding its physiological functions. The LPA gene diverged from the plasminogen gene, likely twice during its evolution, early in hedgehogs and later in a subset of primates. Lp(a) presents a unique setting as a lipoprotein under strong genetic control and with less likelihood of levels being influenced by lifestyles and lipid-lowering therapies. Recent developments, including PCSK9 inhibitors, open novel possibilities for intervention. Other notable Lp(a) features include an intraindividual stability across the lifespan, presence of a 1000-fold interindividual variability, a distinct ethnic-specific difference, and a strong impact by a size polymorphism in the LPA gene. The interest in Lp(a) has expanded beyond CVD to kidney/liver disease, diabetes, and inflammatory conditions. |
