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Physiological Roles and Functions of Lipoprotein(a)

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Lipoprotein(a)

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Lipoprotein(a) (Lp(a)) is highly established as a risk factor for atherosclerotic cardiovascular disease and aortic valve calcification. It is a highly enigmatic lipoprotein whose range of physiologic functions is as yet incompletely described. Structurally, it is a low-density lipoprotein particle that is covalently bound with the glycoprotein apoprotein(a) via noncovalent interactions as well as a disulfide linkage to apoprotein B100. Apoprotein(a) has significant sequence homology with plasminogen and is comprised of a series of tandem kringle domains. In this chapter, we will explore the physiologic functions of Lp(a), which are quite varied. Lp(a) is atherogenic by virtue of the fact that it is an LDL particle, and it is an important transport vehicle for oxidized phospholipids. Lp(a) is prothrombotic, can stimulate platelet aggregation, and is associated with increased risk for venous thromboembolic phenomena. Lp(a) can be dualistic in that it can both potentiate and inhibit inflammation, and it is associated with heightened risk for some cancers, and lower risk for others. Under some conditions, Lp(a) functions as an acute phase reactant, and autoantibodies against Lp(a) have been found in some autoimmune diseases. Lp(a) participates in angiogenesis and wound healing. Elevated serum levels of Lp(a) appear to be protective against the development of diabetes mellitus.

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Authors and Affiliations

  1. Osler Medical House Staff, The Johns Hopkins Hospital, Baltimore, MD, USA

    Zaid N. Safiullah

  2. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Thorsten Leucker, Steven R. Jones & Peter P. Toth

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  1. Zaid N. Safiullah
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  1. Mater Hospital, University of Queensland, Brisbane, QLD, Australia

    Karam Kostner

  2. Medical University of Graz, Graz, Austria

    Gerhard M. Kostner

  3. Ciccarone Center for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Peter P. Toth

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Safiullah, Z.N., Leucker, T., Jones, S.R., Toth, P.P. (2023). Physiological Roles and Functions of Lipoprotein(a). In: Kostner, K., Kostner, G.M., Toth, P.P. (eds) Lipoprotein(a). Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-031-24575-6_8

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