Center for Interdisciplinary Cardiovascular Sciences (M.A.R., F.B.-L., K.H.Z., C.L.C., T.A., S.K., M.C.B., K.A.P., M.A., S.A.S., E.A.), Brigham and Women's Hospital, Harvard Medical School, Boston, MA.
Department of Vascular Medicine, Academic Medical Center, Amsterdam UMC, the Netherlands (K.H.Z., E.S.G.S.).
Circulation. 2024 Jan 30;149(5):391-401. doi: 10.1161/CIRCULATIONAHA.123.066822. Epub 2023 Nov 8.
BACKGROUND: High circulating levels of Lp(a) (lipoprotein[a]) increase the risk of atherosclerosis and calcific aortic valve disease, affecting millions of patients worldwide. Although atherosclerosis is commonly treated with low-density lipoprotein-targeting therapies, these do not reduce Lp(a) or risk of calcific aortic valve disease, which has no available drug therapies. Targeting Lp(a) production and catabolism may provide therapeutic benefit, but little is known about Lp(a) cellular uptake. METHODS: Here, unbiased ligand-receptor capture mass spectrometry was used to identify MFSD5 (major facilitator superfamily domain containing 5) as a novel receptor/cofactor involved in Lp(a) uptake. RESULTS: Reducing expression by a computationally identified small molecule or small interfering RNA suppressed Lp(a) uptake and calcification in primary human valvular endothelial and interstitial cells. variants were associated with aortic stenosis (=0.027 after multiple hypothesis testing) with evidence suggestive of an interaction with plasma Lp(a) levels. CONCLUSIONS: knockdown suppressing human valvular cell Lp(a) uptake and calcification, along with meta-analysis of variants associating with aortic stenosis, supports further preclinical assessment of in cardiovascular diseases, the leading cause of death worldwide.
背景:循环中高水平的脂蛋白(a)(Lp(a))增加了动脉粥样硬化和钙化主动脉瓣疾病的风险,影响了全球数以百万计的患者。尽管动脉粥样硬化通常采用靶向低密度脂蛋白的治疗方法进行治疗,但这些方法并不能降低 Lp(a)或钙化主动脉瓣疾病的风险,而这种疾病目前尚无可用的药物治疗方法。靶向 Lp(a)的产生和分解代谢可能会带来治疗益处,但人们对 Lp(a)的细胞摄取知之甚少。 方法:在这里,使用无偏见的配体-受体捕获质谱法鉴定 MFSD5(主要易化超级家族结构域包含 5)为一种新型受体/辅助因子,参与 Lp(a)的摄取。 结果:通过计算确定的小分子或小干扰 RNA 降低表达,可抑制原代人瓣膜内皮细胞和间质细胞中的 Lp(a)摄取和钙化。 变体与主动脉瓣狭窄相关(经多次假设检验后=0.027),并提示与血浆 Lp(a)水平存在相互作用的证据。 结论:抑制人类瓣膜细胞 Lp(a)摄取和钙化的敲低,以及与主动脉瓣狭窄相关的 变体的荟萃分析,支持进一步对心血管疾病进行临床前评估,心血管疾病是全球死亡的主要原因。
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