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Updated: Mar 3, 2026

A High-Throughput Luciferase Assay to Evaluate Proteolysis of the Single-Turnover Protease PCSK9
Published on: August 28, 2018
Physiological and therapeutic regulation of PCSK9 activity in cardiovascular disease
Simon Glerup1, Rainer Schulz2, Ulrich Laufs3
1Department of Biomedicine, Aarhus University, 8000, Aarhus C, Denmark.
Insights
Proprotein convertase subtilisin/kexin type 9 (PCSK9) regulates LDL-C, a key factor in heart disease. Recent research highlights PCSK9
Area of Science:
- Cardiovascular Biology
- Lipid Metabolism
- Pharmacology
Background:
- Ischemic heart disease is a leading global cause of death, often exacerbated by high LDL-C levels.
- Proprotein convertase subtilisin/kexin type 9 (PCSK9) plays a critical role in regulating LDL-C by promoting LDL receptor degradation.
- Recent advancements have elucidated the complex regulation of PCSK9 activity at multiple biological levels.
Purpose of the Study:
- To review recent biological and clinical data concerning PCSK9.
- To discuss the regulation of PCSK9, including its transcription, secretion, and extracellular inactivation.
- To explore the extra-hepatic roles of PCSK9, particularly in cardiovascular cells.
Main Methods:
- Literature review of recent biological and clinical studies on PCSK9.
- Analysis of regulatory mechanisms influencing PCSK9 activity.
- Examination of PCSK9's physiological and pathological roles in cardiovascular cells.
Main Results:
- PCSK9 activity is tightly regulated through various mechanisms.
- PCSK9 has significant roles beyond hepatocytes, impacting cardiovascular cells.
- Approved PCSK9-targeting antibodies and ongoing clinical trials show promise in reducing cardiovascular events.
Conclusions:
- PCSK9 is a crucial target for managing hypercholesterolemia and reducing cardiovascular risk.
- Understanding PCSK9's multifaceted roles is essential for developing effective therapeutic strategies.
- Further clinical data will clarify the long-term impact of PCSK9 inhibition on cardiovascular outcomes.
Abstract:
Ischemic heart disease is the main cause of death worldwide and is accelerated by increased levels of low-density lipoprotein cholesterol (LDL-C). Proprotein convertase subtilisin/kexin type 9 (PCSK9) is a potent circulating regulator of LDL-C through its ability to induce degradation of the LDL receptor (LDLR) in the lysosome of hepatocytes. Only in the last few years, a number of breakthroughs in the understanding of PCSK9 biology have been reported illustrating how PCSK9 activity is tightly regulated at several levels by factors influencing its transcription, secretion, or by extracellular inactivation and clearance. Two humanized antibodies directed against the LDLR-binding site in PCSK9 received approval by the European and US authorities and additional PCSK9 directed therapeutics are climbing up the phases of clinical trials. The first outcome data of the PCSK9 inhibitor evolocumab reported a significant reduction in the composite endpoint (cardiovascular death, myocardial infarction, or stroke) and further outcome data are awaited. Meanwhile, it became evident that PCSK9 has (patho)physiological roles in several cardiovascular cells. In this review, we summarize and discuss the recent biological and clinical data on PCSK9, the regulation of PCSK9, its extra-hepatic activities focusing on cardiovascular cells, molecular concepts to target PCSK9, and finally briefly summarize the data of recent clinical studies.
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