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脂蛋白 (a):风险因素,测量和新治疗方法的审查

Avrohom Karp¹, Menachem Jacobs², Ben Barris¹

¹From the Department of Medicine, New York Medical College/Westchester Medical Center, Valhalla, NY.

Cardiology in review

|February 28, 2024

概括

脂蛋白 (Lp) 是动脉样硬化心血管疾病 (ASCVD) 的潜在独立风险因素. 针对Lp (a) 的新兴疗法可能为管理心血管风险提供新的途径.

科学领域:

心脏病学心脏病学
遗传学遗传学是一个
药理学药理学是指药理学的学科.

背景情况:

脂蛋白 (Lp) 越来越多地被认为是动脉样硬化心血管疾病 (ASCVD) 的独立风险因素.
早期的研究由于敏感度较低的测试而存在局限性,但最近的大规模遗传和观察性研究强烈支持Lp(a) -ASCVD联系.
目前对Lp(a) 测试的指导方针因其在ASCVD中的不确定的作用而有所不同.

研究的目的:

审查Lp (a) 导致动脉样硬化的机制.
探索正在开发的新型药理疗法,以降低Lp (a) 水平.
阐明升高的Lp (a) 和心血管风险之间的联系.

主要方法:

大规模观测研究,全基因组关联研究和门德尔随机化研究的综述.
对针对mRNA翻译以减少Lp的新兴治疗策略的分析.
对Lp的异原体机制的检查.

主要成果:

来自多种研究类型的强有力的证据支持Lp (a) 作为ASCVD的风险因素.
新的疗法,包括反感性寡核酸和小干扰RNA,正在开发中,以降低Lp.
这些疗法旨在澄清Lp(a) 在ASCVD中的作用,并提供临床管理工具.

结论:

脂蛋白是动脉样硬化心血管疾病的重要,独立的风险因素.
新型向疗法对管理升高的Lp(a) 和降低心血管风险具有前景.
进一步的研究至关重要,以充分了解Lp(a) 的异原性,并优化治疗策略.

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