IntroductionLipoprotein(a) [Lp(a)] is a plasma lipoprotein whose structure and composition closely resembles that of low density lipoprotein (LDL), but with one of additional molecule of apolipoprotein(a) [apo(a)], a large glycoprotein linked to apoB by a disulfide bond (Figure 1) [1,2]. High Lp(a) levels have been established as an independent risk factor for atherocslerosis [3][4][5], and Lp(a) deposits have been found in atherosclerotic lesions but not in normal arterial walls [6][7][8].Lp(a) can be modified by oxidation in vitro, and then be taken up by macrophages by means of scavenger receptors, where it promotes their transformation into foam cells within the arterial walls [9][10][11][12][13]. Oxidized Lp(a) [ox-Lp(a)] may also induce adhesion molecular expression on monocytes, promoting their recruitment and adhesion to the endothelium [14], and influence the responsiveness of platelets to various agonists [15]. Modified forms of Lp(a), some resembling oxidized Lp(a), have been identified in human atheromatous lesions [16]. In addition, ox-Lp(a) causes significant changes in apo(a) conformation, which could enhance the interaction of these particles with plasminogen binding sites as well as macrophage scavenger receptors, resulting in increased inhibitory effect on plasminogen activation and finally leading to attenuate fibrinolytic activity [17].Ox-Lp(a) has been reported to play more potent role than native Lp(a) in atherosclerosis [10,14,17,18], and autoantibodies against ox-Lp(a), Lp(a) immune complexes [Lp(a)-IC] have also been detected in vivo simultaneously [19,20]. The present review article focuses specifically on the relationship between Lp(a) oxidation, autoimmune and atherosclerosis together with our recent work.
The pathogenic role of oxidized Lp(a)Lp(a) contains a large specific glycoprotein called apo(a), attached by a single disulfide bridge to apoB 100 of LDL (Figure 1). The adverse cardiovascular qualities of Lp(a) have been related to both its LDL-like properties (i.e., formation of foam cells) and its presumed role in fibrinolysis.
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Lp(a) oxidationThe structure, fatty acid composition, and antioxidant concentrations of Lp(a) and LDL are quite similar [21]. In vitro studies have shown that Lp(a) can be modified by oxidation (both chemical and cellular-mediated) in a fashion similar to LDL [22]. This modification, which involved lipid peroxidation measured as thiobarbituric acid-reactive substances (TBARS), caused marked changes in the structure and biological properties of Lp(a). Relative to native Lp(a), oxidized particles showed decreases of free amino groups and protein fragmentation, increased negative charge, and high aggregation ability. They were taken up and degraded readily by human monocyte/macrophages by means of scavenger receptors, a known pathway for clearance of ox-LDL in atheroma, inducing cholesteryl ester accumulation and promoting their transformation into foam cells within the arterial w...