(Adnkronos) - “La lipoproteina (a) è una Ldl, cioè una lipoproteina a bassa densità, come quella che veicola nel nostro corpo il cosiddetto ‘colesterolo cattivo’. A differenza di quest’ultima però, è associata all’apoproteina (a), e questo fa sì che diventi molto proinfiammatoria, proateriosclerotica e protrombotica, assumendo quindi una connotazione patogena importante. In termini di aterosclerosi, la lipoproteina (a) ha una capacità di circa 6 volte superiore rispetto all’Ldl”. Così Claudio Bilato, direttore della Cardiologia degli ospedali dell'Ovest vicentino e professore presso la Scuola di specializzazione in Malattie dell’apparato cardiovascolare dell’università di Padova, al media tutorial ‘Non solo colesterolo Ldl: alla scoperta della Lipoproteina (a)’ tenutosi a Milano.
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00:00What is the link between small lipoprotein and atherosclerotic disease?
00:04Small lipoprotein was discovered more than 60 years ago by a Norwegian doctor, Carl Berge.
00:11Since then, however, it has been the subject of numerous epidemiological observations,
00:17especially in Scandinavian countries.
00:19There has been a profound linear correlation between the levels of small lipoprotein circulating
00:26and cardiovascular diseases on the basis of atherosclerotic disease.
00:30What has been observed, thanks to these epidemiological observations,
00:36is that, in fact, in patients who already had a significant cardiovascular risk level,
00:43because there were other risk factors, such as hypertension, smokers,
00:48had higher LDL cholesterol, the addition of this other element,
00:53small lipoprotein, increases this risk exponentially.
00:58Therefore, the identification of this lipoprotein is essential
01:03in order to reduce the cardiovascular risk of the patient.
01:06Small lipoprotein is basically an LDL,
01:11that is, a low-density lipoprotein,
01:15like the one that carries bad cholesterol in our body.
01:19But, together, it is associated with another protein,
01:25which is called small lipoprotein,
01:28and which gives a much more important pathogenic connotation,
01:32because it becomes very pro-inflammatory, pro-atherosclerotic and pro-thrombogenic.
01:37Therefore, the capacity of this small lipoprotein,
01:42which is no longer an LDL, but a modified LDL,
01:45increases, in terms of atherosclerosis, much more, about 6 times.
01:50Therefore, it is essential to act on this element.
01:53Until now, we did not have really effective pharmacological instruments.
01:58At the best, we were able to lower the levels by about 30%.
02:02Currently, two types of molecules are being studied.
02:06They are all molecules that silence the gene,
02:09that is, they block the production of this small lipoprotein.
02:14One of these is a molecule called oligonucleotide antisense,
02:19which has the ability to reduce the circulating levels of small lipoprotein by 80-85%.
02:25This molecule is currently the subject of a very important,
02:30multicentric, multinational, long-term study,
02:34which tries to assess whether,
02:36by lowering, as we know, the levels of small lipoprotein,
02:40there is also a significant reduction of cardiovascular events.