Lipoprotein(a): from molecules to therapeutics

Am J Ther. 2010 May-Jun;17(3):263-73. doi: 10.1097/MJT.0b013e3181e00bf1.

Abstract

Lipoprotein (a) [Lp(a)] was discovered by Kare Berg in 1963 from the study of low-density lipoprotein genetic variants. Lp(a) contains a unique protein, apolipoprotein(a), which is linked to the Apo B-100 through a disulfide bond that gives it a great structural homology with plasminogen, and confers it atherogenic and atherothrombotic properties. Interest in Lp(a) has increased because an important association between high plasma levels of Lp(a) and coronary artery disease and cerebral vascular disorders has been demonstrated. Numerous case control studies have confirmed that hyper-Lp(a) is a risk factor for premature cardiovascular disease. Lp(a) is identified as a genetic trait with autosomal transmission, codified by one of the most studied polymorphic genes in humans. It has been demonstrated that variations in this gene are a major factor in the serum levels of Lp(a). Variations differ considerably between individuals and sex across populations. Various approaches to drug treatment using fibric acid derivatives, growth hormone, insulin-like growth factor-1, alcohol extracted soy protein, niacin, and exercise have been proven to decrease Lp(a) in high risk patients, but none has really been an effective therapeutic option for successfully reducing Lp(a) plasma levels.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Cardiovascular Diseases / etiology
  • Cardiovascular Diseases / prevention & control*
  • Cerebrovascular Disorders / etiology
  • Cerebrovascular Disorders / prevention & control
  • Coronary Artery Disease / etiology
  • Coronary Artery Disease / prevention & control
  • Female
  • Humans
  • Hyperlipoproteinemias / complications*
  • Hyperlipoproteinemias / drug therapy
  • Lipoprotein(a) / blood*
  • Lipoprotein(a) / drug effects
  • Lipoprotein(a) / genetics
  • Male
  • Polymorphism, Genetic
  • Risk Factors

Substances

  • Lipoprotein(a)