Pathophysiological aspects of lipoprotein-associated phospholipase A2: A brief overview

Abstract

Macrophages are known to produce significant amount of lipoprotein- associated phospholipase A2 (Lp-PLA2). In human plasma Lp-PLA2 circulates in association with low- and high-density lipoproteins (LDL and HDL), where LDL- associated Lp-PLA2 was found to be associated with atherosclerosis lesions. Studies have also suggested that LDL and the modified forms of LDL such as oxidized LDL (oxLDL) and glycated LDL (gLDL), and also apolipoprotein E (apoE) isoforms, are also found to be associated with Lp-PLA2 for initiation and progression of vascular lesions. Additionally, Chlamydia pneumoniae infection can increase Lp-PLA2activity in the macrophages of atherosclerotic plaque. In adolescents, Lp-PLA2 changes occur with obesity and it shows important association with markers of cardiovascular disorder. Lp-PLA2 levels can be lowered by two main pharmacologic interventions-indirectly, by lowering LDL, or directly, by lowering Lp-PLA2 activity. Notably, darapladib (a product of GlaxoSmithKline) is now considered as an important therapeutic agent to inhibit Lp-PLA2 activity. However, some studies are still in progress to determine its pharmacokinetics and to prove it as a safe drug.