Viewing the Cardiovascular Pathogenicity of Lp(a) from the Pro-Inflammatory Side

Lipoprotein(a), Lp(a), represents a class of lipoproteins characterized by having a single mole of poB100 covalently linked to a single mole of apolipoprotein(a), apo(a), a multikringle structure with close homology to lasminogen. High plasma levels of Lp(a) have been associated with an increased incidence of atherosclerotic cardiovascular disease by mechanisms yet poorly defined. The structural and functional properties of Lp(a) have directed early attention to the. proatherogenic and prothrombotic properties of this lipoprotein. However, recent studies have uncovered an additional mechanism dealing with oxidative-derived post-translational changes promoting the chemical linkage of apo(a) to proinflammatory oxidized phosphatidylcholine (ox-PC). The scope of this review is to critically examine the available information on this subject in the context of the overall cardiovascular pathogenicity of Lp(a) taking into account the underlying notion of atherosclerosis as a chronic inflammatory process and also comment on the potential therapeutic implications of these new findings.