Lipoprotein(a) the Insurgent: A New Insight into the Structure, Function, Metabolism, Pathogenicity, and Medications Affecting Lipoprotein(a) Molecule

Abstract

Lipoprotein(a) [Lp(a)], aka “Lp little a”, was discovered in the 1960s in the lab of the Norwegian physician Kåre Berg. Since then, we have greatly improved our knowledge of lipids and cardiovascular disease (CVD). Lp(a) is an enigmatic class of lipoprotein that is exclusively formed in the liver and comprises two main components, a single copy of apolipoprotein (apo) B-100 (apo-B100) tethered to a single copy of a protein denoted as apolipoprotein(a) apo(a). Plasma levels of Lp(a) increase soon after birth to a steady concentration within a few months of life. In adults, Lp(a) levels range widely from <2 to 2500 mg/L. Evidence that elevated Lp(a) levels >300 mg/L contribute to CVD is significant. The improvement of isoform-independent assays, together with the insight from epidemiologic studies, meta-analyses, genome-wide association studies, and Mendelian randomization studies, has established Lp(a) as the single most common independent genetically inherited causal risk factor for CVD. This breakthrough elevated Lp(a) from a biomarker of atherosclerotic risk to a target of therapy. With the emergence of promising second-generation antisense therapy, we hope that we can answer the question of whether Lp(a) is ready for prime-time clinic use. In this review, we present an update on the metabolism, pathophysiology, and current/future medical interventions for high levels of Lp(a).

Associations among Lipoprotein (a) and Apolipoproteins (A1, B100, E) Status in Bangladeshi Patients with Cholelithiasis and Effects of Laparoscopic Cholecystectomy on the Status

“…Apo(a) and ApoB100. Jaw et al recently opined that Lp(a) may be ready for prime time clinical use to monitor GD [38]. Abnormalities in lipids and apolipoproteins metabolism may, however, arise from a combination of various factors such as excess dietary cholesterol/fat, obesity, diabetes, deficient antioxidant system and genetic factors [2,36,37,39,40].…”

Lipoprotein(a) Where Do We Stand? From the Physiopathology to Innovative Terapy

“…Lp(a) is a cholesterol containing lipoprotein including a cholesterol rich, LDL like particle, apolipoprotein B100 (apo B100), covalently bound to an additional apolipoprotein called apolipoprotein a (apo a) [6]; this particular and complicated feature makes it completely different from low density lipoprotein cholesterol (LDL-C) [7].…”

Lipoproteomics: Methodologies and Analysis of Lipoprotein-Associated Proteins along with the Drug Intervention

“…When the lipoprotein complex is formed, the orientation of the hydrophilic proportions is toward the outside and the lipophilic proportions toward the interior; this structural characteristic allows the complex to have the ability to emulsify fats in extracellular fluids [8]. Based on their density defined by the protein to lipids ratios, lipoproteins are grouped into six classes: chylomicrons, very low density lipoproteins (VLDL), intermediate density lipoproteins (IDL), low density lipoproteins (LDL), high density lipoproteins (HDL), and lipoprotein (a) [Lp (a)] [8,9].…”