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Lipoprotein-as­sociated phospholipase A2 and the risk of ischemic stroke


Authors: Ľ. Danihel 1,2;  Š. Madarász 2,3;  P. Blažíček 4,5;  A. Lacko 2,6;  J. Luha 7;  V. Lehotská 8,9
Authors‘ workplace: Rádiologická klinika ÚVN SNP Ružomberok – FN, Ružomberok 1;  Fakulta zdravotníctva, Katolícka univerzita, Ružomberok 2;  Neurologická klinika ÚVN SNP Ružomberok – FN, Ružomberok 3;  Ústav chémie, klinickej biochémie a labo­ratórnej medicíny, LF SZU v Bratislave 4;  Laboratórium 4vive, Bratislava 5;  Interná klinika, Kardiologická ambulancia, ÚVN SNP Ružomberok – FN, Ružomberok 6;  Ústav lekárskej biológie, genetiky a klinickej genetiky, LF UK a UN, Bratislava 7;  II. Rádiologická klinika, LF UK A UN, Bratislava 8;  Onkologický ústav svätej Alžbety, Bratislava 9
Published in: Cesk Slov Neurol N 2018; 81(3): 308-313
Category: Original Paper
doi: https://doi.org/10.14735/amcsnn2018308

Práca bola podporená projektom Európskej únie Mechanizmy a nové markery vzniku a priebehu cirkulárnych porúch mozgu ITMS 26220220099.

Overview

Aim:
Lipoprotein-associated phospholipase A2 (Lp-PLA2) is an enzyme accumulated in atherosclerotic plaques and causes plaques inflammation that can induce plaque rupture. The aim of this work is to compare serum Lp-PLA2 concentration in healthy subjects and in patients with arterial hypertension (AH), ischemic heart disease (IHD) and ischemic stroke (IS) so that we could assess utility of Lp-PLA2 as a biomarker for IS risk. AH and IHD are considered risk factors for IS, therefore we measured serum Lp-PLA2 concentration also in patients with these diseases.

Methods:
Serum Lp-PLA2 concentration was determined by diaDexus PLAC® Test ELISA Kit (Diadexus, Inc., San Francisco, USA), a sandwich enzyme immunoassay. The statistical analysis was performed with IBM SPSS Statistics 24 (IBM Corp., New York, USA) using the Fisher’s exact test and non-parametric correlations.

Results:
Our cohort comprised of 401 subjects in total (43% males), 80 subjects in the group of healthy individuals (35% males), 96 subjects in the group with AH (43% males), 85 subjects in the group with IHD (39% males) and 140 subjects in the group with IS (49% males). Serum Lp-PLA2 concentration in the group of healthy individuals was significantly lower than that in the group with AH (p = 0 × 10–3), IHD (p = 0 × 10–3) and IS (p = 0 × 10–3).

Conclusion:
Our study confirmed the assumption that people with AH, IHD and IS have higher levels of serum Lp-PLA2 concentration than healthy people hence a higher incidence of inflamed atherosclerotic plaques and higher risk of rupture of these plaques, but a higher level of serum Lp-PLA2 persisted in people with AH, IHD and IS in our cohort despite the statin therapy, leading us to conclude that the role of Lp-PLA2 in the development and intensification of atherosclerotic plaque inflammation may be more complicated than only the hydrolysis of oxidized LDL in atherosclerotic plaque.

Key words:
lipoprotein-associated phospholipase A2 – atherosclerosis – ischemic stroke

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE “uniform requirements” for biomedical papers.


Sources

1. Staf­forini DM. Biology of platelet-activat­­ing factor acetylhydrolase (PAF-AH, lipoprotein as­sociated phospholipase A2). Cardiovasc Drugs Ther 2009; 23(1): 73– 83. doi: 10.1007/ s10557-008-6133-8.

2. Kol­lár J. (Bio)markery vulnerabilných plátov a prediktabilita ischemických príhod. In: Kol­lár J. Aterotrombóza-patofyziológia a epidemiológia. Košice: Equilibria 2016: 65– 85.

3. Franeková J, Jabor A. Fosfolipáza A2 asociovaná s lipoproteiny –  nový marker kardiovaskulárního rizika. Postgraduální med 2010; 12 (Suppl 3): 32– 42.

4. Greenland P, Alpert JS, Bel­ler GA et al. 2010 ACCF/ AHA guideline for as­ses­sment of cardiovascular risk in asymp­tomatic adults: a report of the American Col­lege of Car­-diology Foundation/ American Heart As­sociation Task Force on Practice Guidelines. Circulation 2010; 122(25): e584– e636. doi: 10.1161/ CIR.0b013e3182051b4c.

5. Piepoli MF, Hoes AW, Agewall S et al. 2016 European guidelines on cardiovascular dis­ease prevention in clinical practice: The Sixth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular dis­ease prevention in clinical practice (constituted by representatives of 10 societies and by invited experts): developed with the special contribution of the European As­sociation for Cardiovascular Prevention & Rehabilitation (EACPR). Eur J Prev Cardiol 2016; 23(11): NP1– NP96. doi: 10.1177/ 2047487316653709.

6. Prescott SM, Mcintyre TM, Zim­merman GA et al. Sol Sher­ry lecture in thrombosis. Molecular events in acute inflam­mation. Arterioscler Thromb Vasc Biol 2002; 22(5): 727– 733. doi: 10.1161/ 01.ATV.0000016153.47693.B2.

7. White HD, Held C, Stewart R et al. Darapladib for prevent­­ing ischemic events in stable coronary heart dis­ease. N Engl J Med 2014; 370(18): 1702– 1711. doi: 10.1056/ NEJMoa1315878.

8. O‘Donoghue ML, Braunwald E, White HD et al. Ef­fect on darapladib on major coronary events after an acute coronary syndrome: the SOLID-TIMI 52 randomized clinical trial. JAMA 2014; 312(10): 1006– 1015. doi: 10.1001/ jama.2014.11061.

9. Rosenson RS, Staf­forini DM. Modulation of oxidative stres­s, inflam­mation, and atherosclerosis by lipoprotein-as­sociatedphospholipase A2. J Lipid Res 2012; 53(9): 1767– 1782. doi: 10.1194/ jlr.R024190.

10. Mas­sot A, Pelegri D, Panalba A et al. Lipoprotein-as­sociatel phosholipase A2 test­­ing usefulness among patients with symp­tomatic intracranial atherosclerotic dis­ease. Atherosclerosis 2011; 218(1): 181– 187. doi: 10.1016/ j.atherosclerosis.2011.04.031.

11. U.S. Food and Drug Administration. 510 (k) Sum­mary diaDexus PLAC TM Test. [online]. Available from URL: https: / / www.acces­sdata.fda.gov/ cdrh_docs/  pdf5/ k050523.pdf.

12. Lanman RB, Wolfert RL, Flem­­ing JK et al. Lipoprotein-accociated phosholipase A2: review and recom­mendation of clinical cut of point for adults. Prev Cardiol 2006; 9(3): 138– 143.

13. McCon­nell JP, Hoefner DM. Lipoprotein-as­sociated phospholipase A2. Clin Lab Med 2006; 26(3): 679– 697.

14. Davidson MH, Corson MA, Alberts MJ et al. Consensus panel recom­mendation for incorporat­­ing lipoprotein-as­sociated phospholipase A2 test­­ing into cardiovascular dis­ease risk as­ses­sment guidelines. Am J Cardiol 2008; 101(12A): 51F– 57F. doi: 10.1016/ j.amjcard.2008.04.019.

15. U.S. Food and Drug Administration. 510 (k) Sum­mary diaDexus PLAC Test for Lp-PLA2 Activity. [online]. Avail­able from URL: https: / / www.acces­sdata.fda.gov/ cdrh_docs/ pdf14/ K141575.pdf.

16. Mayo Clinic. Mayo Medical Laboratories. Lipoprotein-as­socated phosholipase A2 (Lp-PLA2) activity. Novel and ef­fective test­­ing for prediction of coronary heart dis­ease.[online]. Available from URL: http: / / www.mayomedical­laboratories.com/ media/ mayo_client/ marketing/ cardiology/  lp-pla2-PLACA-brochure-1115b.pdf.

17. O‘Riordan M. FDA approves Lp-PLA2 test for patients without exist­­ing coronary dis­ease. [online]. Avail­able from URL: http: / / www.medscape.com/ viewarticle/ 836640.

18. Jabor B, Choi H, Ruel I et al. Lipoprotein-as­sociated phospholipase A2 (Lp-PLA2) in acute coronary syndrome: relationship with low-density lipoprotein cholesterol. Can J Cardiol 2013; 29(12): 1679– 1686. doi: 10.1016/ j.cjca.2013.09.026.

19. Kara H, Akinci M, Degirmenci S et al. High-sensitivity C-reactive protein, lipoprotein-related phospholipase A2, and acute ischemic stroke. Neuropsychiatr Dis Treat 2014; 10: 1451– 1457. doi: 10.2147/ NDT.S67665.

20. Tai W, Garcia M, Mlynash M et al. Lipoprotein phospholipase A2 mass and activity are not as­sociated with the dia­gnosis of acute brain ischemia. Cerebrovasc Dis 2014; 38(5): 324– 27. doi: 10.1159/ 000368218.

21. Elkind MSV, Leon V, Moon YP et al. High-sensitivity C-Reactive protein and lipoprotein-as­sociated phospholipase A2 stability before and after stroke and myocardial infarction. Stroke 2009; 40(10): 3233– 3237. doi: 10.1161/ STROKEAHA.109.552802.

22. Kocak S, Ertekin B, Girisgin AS et al. Lipoprotein-as­sociated phospholipase A2 activity and its dia­gnostic potential in patients with acute coronary syndrome and acute ischemic stroke. Turk J Emerg Med 2016; 17(2): 56– 60. doi: 10.1016/ j.tjem.2016.10.001.

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Paediatric neurology Neurosurgery Neurology

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Czech and Slovak Neurology and Neurosurgery

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