Several lines of evidence suggest that hdlassociated lppla2 may substantially contribute to the hdl antiatherogenic activities. In multivariable analyses, lppla2 mass and activity were strongly associated with cardiovascular events after controlling for traditional risk factors, severity of. At the baseline, the two groups were statistically similar in terms of these variables. Biochemical differences in the mass and activity tests of.
The activity of lppla2 and levels of lipid and glycemic parameters were. The plac test is a blood test used to measure serum activity of lipoproteinassociated phospholipase a2 lppla2, an enzyme that breaks down oxidized low. While high plasma lppla2 activity was reported as a risk factor for dementia in the rotterdam study, no association between lppla2 mass and dementia or alzheimers disease ad was detected in the framingham study. Lipoproteinassociated phospholipase a2 lp pla2 is a circulating enzyme with proinflammatory and oxidative activities associated with cardiovascular disease and ischemic stroke. Although, the role of lp pla2 in atherosclerosis may depend on its carrier in plasma, and several lines of evidence suggest that hdlassociated lp pla2 may substantially contribute to the hdl antiatherogenic activities. Lipoproteinassociated phospholipase a2 activity predicts.
Dietary intake was analyzed in terms of energy and. The possibility of reducing the lppla2 mass level using simvastatin. Lipoproteinassociated phospholipase a2 activity and mass. The genetic approach has allowed us in an important way of there. The distribution of lp pla2 over lipoprotein classes correlates with the pathophysiological state of individuals 3. Lipoproteinassociated phospholipase a 2 lp pla 2 is a unique circulating phospholipase with inflammatory and oxidative activities and the limited data regarding the relationship between lp pla 2 and cognitive impairment are conflicted. Forty percent n 618 of subjects with elevated lp pla2 activity top tertile had levels of lp pla 2 mass in the lowest or middle tertile. Lp pla2 activity is to be used in conjunction with clinical evaluation and patient risk assessment as an aid in. Lppla2 on the other hand is marketed as a marker that is specific for vascular inflammation. The final decision on which test to use for lp pla 2 determination, test based on mass or activity of lp pla 2, together with the development of commercially available automated, robust, valid, high throughput, costeffective test capable of increasing agility and reducing the analytical imprecision can be adopted routinely in clinical practice.
Lipoproteinassociated phospholipase a2 is associated with. The plasma levels and activity of lppla 2 are significantly elevated in patients with cad and ischemic stroke risk 72, 105. The urgent test for heart disease lipoproteinassociated phospholipase a2 lp pla2 its a mouthful, but for the sake of your heart, its a good idea to get to know it. The lppla 2 activity test is recommended if you have two or more risk factors for heart disease, such as high cholesterol or obesity. Associations of lp pla2 mass and activity are not exclusive to vascular outcomes, and the vascular associations depend at least partly on lipids. Elevated lppla 2 levels add prognostic information of the metabolic syndrome on incidence of cardiovascular events among middleaged nondiabteic subjects.
Secretory phopholipase a2 pla2 enzymes cleave an acyl ester bond in the sn2 position of glycerophospholipids. Test activity 2014 for enzymatic activity in order to improve diagnostics and. Measurement of lipoproteinassociated phospholipase a2 lp pla2 in the assessment of cardiovascular risk 2 regulatory status the u. Your guide to lowering heart disease and stroke risk an introduction to berkeley heartlabs test results bunny foxhoven, rd, ce. This test looks for a specific lipoprotein, lp pla2, in your blood. Lppla2 mass was also associated with moderate to severe icas no matter how was the ecas. It is known that the major sources of the plasma lp pla2 are monocytederived macrophages and liver cells.
Lp pla2 is carried to the coronary artery walls by ldl, where it causes an inflammatory response. Lp pla 2, or lipoproteinassociated phospholipasea 2, measures disease activity within the artery wall below the collagen or calcified cap due to the activation of macrophages. Moreover, lppla2 can hydrolyze plateletactivating factor in platelets, monocytes, and macrophages 12. We carried out a genomewide association study of lp pla 2 activity and mass in 6,668 caucasian. Lipoproteinassociated phospholipase a2 measurements. Lipoproteinassociated phospholipase a 2 lppla 2 is a 50kda calciuminsensitive lipase produced predominantly by macrophages and lymphocytes.
Based on these evidences the major scientific societies have included in their guidelines the measurement of lp pla2 activity among the biomarkers that are useful. Temporal profile and prognostic value of lppla2 mass and. Lp pla2 is an enzyme associated with low density lipoprotein ldl. The association of lp pla2 with lipoproteins is dependent on its glycosylation pattern 4. The beneficial effects of alpha lipoic acid supplementation. Lipoproteinassociated phospholipase a2 activity and mass as. The greater the lp pla 2 activity, the greater the risk for fatal and nonfatal chd events figure 1 a plac activity test result above 225 nmolminml identifies patients at increased risk for chd events across patient type and population figure 2 absolute risk of chd events is 2.
Retest results are to be multiplied by the dilution factor. Lipoproteinassociated phospholipase a2 lppla2 is a circulating enzyme with proinflammatory and oxidative activities associated with cardiovascular disease and ischemic stroke. Lppla2 placcardiacriskmarker is a test used in measuring the amount of lipoprotein associated phospholipase lp pla2 in blood. After adjustment for traditional atherosclerosis risk factors and creactive protein concentrations, lp pla2 mass and activity were not associated with aap or awt in either sex, but lp pla2 mass remained modestly associated with detectable cac only in men odds ratio 1. The plac activity test provides physicians with additional prognostic information that was previously unavailable with traditional risk factors. Studies were included if they reported lp pla2 mass andor activity levels and adjusted risk estimates of stroke. Lppla2 activity and mass are strongly associated with both atherogenic. Lp pla2 reflects inflammation in the atherosclerotic plaque and its activity is associated with macrophages, which are specialized white blood cells found in areas of inflammation. Food and drug administration fda cleared for marketing an enzymelinked. The lp pla 2 activity test measures the activity or actions of lp pla 2 in the bloodstream. The test is used to help predict your risk for cardiovascular disease and stroke.
Lppla2 concentration mass when the lppla2 activity test is resulted. The new plac test for lppla2 activity enzo clinical labs. Lipoprotein associated phospholipase a2 lp pla2 is a novel inflammatory factor that has been independently associated with stroke and cardiovascular disease cvd. Risk ratios were simi lar, whether the mass concentration or activity of the en zyme was measured. Lipoproteinassociated phospholipase a2 lppla2 is a novel biomarker for vascular wall inflammation that circulates in the blood bound to both low density ldl and high density hdl lipoprotein and promotes vascular inflammation. Lipoproteinassociated phospholipase a2 and coronary heart. Inflammatory biomarker of vascular risk in multiple.
The lp pla2 activity test controls are intended for use as a quality control tool to monitor the performance within the clinical range of the plac test for lp pla2 activity, an enzyme assay for the quantitative determination of lp pla2 activity. When disease is active in the artery, increased levels of lppla 2 are produced by macrophages and. The concordance between lp pla 2 activity and mass in tertiles is depicted in table 2. The activity and mass of this enzyme are heritable traits, but major genetic determinants have not been explored in a systematic, genomewide fashion. At present lp pla 2 testing is recommended in 4 major guidelines for patients estimated to be at moderate or high cvd risk by traditional risk assessment guideline for management of dyslipidemia and prevention of atherosclerosis by the american association of clinical endocrinologists 2012. Lp pla 2 is an enzyme that can assess the amount of inflammation in your arteries due to a buildup of cholesterol. Lipoproteinassociated phospholipase a2 mass and activity. The association of cardiovascular events with lp pla2 has been studied continuously today. The greater the lppla 2 activity, the greater the risk for fatal and nonfatal chd events figure 1 a plac activity test result above 225 nmolminml identifies patients at increased risk for chd events across patient type and population figure 2 absolute risk of chd events is 2. Samples with lp pla 2 activity level exceeding the linearity limit of 2000 ul should be diluted with saline 0. The possibility of reducing the lppla2 mass level using. Lp pla2 mass and its distribution among hdl and apob. The heart protection study hps also showed that simvastatin reduced lp pla2 activity by 25%, but the effects of simvastatin on vascular outcomes did not vary according totable 3subgroup analyses. Despite significant advances in heart attack prevention over the past 40.
Lipoproteinassociated phospholipase a2 american journal of. The changes in total lppla2 mass, hdllppla2, apobassociated lppla2, and percent of hdllppla2 across the time are presented in figure 2. The plasma biomarkers lipoproteinassociated phospholipase a2 lp pla2 activity and mass, proneurotensin, and crp, were studied in relation to incidence of pad until december 31st, 2016. Elevated lp pla2 mass and activity appears to be associated with increased risk for chd. Lppla2 mass level and cholesterol fractions were determined at baseline and. Pla2 plays an important role in the process of atherosclerosis and participates in the development of plaque.
This finding suggests that these biomarkers indicate subclinical pad prior to onset of symptoms due to pad. Lppla2 activity assay kit research use only ruo doc. May 01, 2010 lppla 2 activity and mass each show continuous associations with risk of coronary heart disease, similar in magnitude to that with nonhdl cholesterol or systolic blood pressure in this population. Sst or red top specimen integrity if hemolyzed, discard specimen and redraw if hemolyzed, discard specimen and redraw. Genomewide association study of lppla2 activity and mass. It is an enzyme produced by inflammatory cells and hydrolyzes oxidized phospholipids in ldl. The plac activity test is an fdacleared test that aids in predicting risk for chd in patients with no prior history of cardiovascular events. Lppla2 and coronary atherosclerosis in humans full text. Hytest ltd intelligate 1, 6th fioor, joukahaisenkatu 6 fi20520 turku, finland tel. Among these markers, lipoprotein associated phospholipase a2 lppla2 has recently received considerable attention. When disease is active in the artery, increased levels of lp pla 2.
While high plasma lp pla2 activity was reported as a risk factor for dementia in the rotterdam study, no association between lp pla2 mass and dementia or alzheimers disease ad was detected in the. Lipoproteinassociated phospholipase a2 and risk of. Plac mass test only detects a small portion of the total lppla2, mainly the lppla2 associated with hdl. Lp pla 2 activity know your risk for heart disease. Lipoproteinassociated phospholipase a2 does this test have other names. Ala significantly decreased the oxldl, total lp pla2 mass, apobassociated lp pla2, and percent of apobassociated lp pla2 and triglyceride and increased the percent of hdl lp pla2 compared with the placebo group but had no significant effect on hdl lp pla2 mass. Lipoprotein associated phospholipase a2 the journal of lipid. At present lppla 2 testing is recommended in 4 major guidelines for patients estimated to be at moderate or high cvd risk by traditional risk assessment.
Lppla 2 activity and mass and crp are associated with incident. Diasys lp pla 2 fs features and benefits enzymatic test determining the activity of lp pla 2 liquidstable, readytouse reagent adaptable on any clinical chemistry analyzer for use in serum, edta and heparin plasma wide measuring range up to 2000 ul 2point calibration with superior stability of 8. There are no changes to the sample type, cpt code, or chl easypay amount. Antioxidant and inflammatory aspects of lipoprotein. Plac mass test only detects a small portion of the total lp pla2, mainly the lp pla2 associated with hdl. Lp pla2 mass levels are due to a decreased catabolismclearance of the lp pla2 by the kidneys table 3. Lipoproteinassociated phospholipase a2 and risk of coronary. We will no longer offer the original plac elisa test that simply determines the mass or amount of lppla2 enzyme in the blood. Your guide to lowering heart disease and stroke risk. The majority of the ldlassociated lp pla2 ldl lp pla2 activity is bound to atherogenic smalldense ldl particles and it is a potential marker of these particles in plasma. Healthcare professionals diazyme plac activity test lppla2.
Crp is a very sensitive marker for inflammation, so if there is any underlying inflammation in my body, it should be elevated. The enzyme has been strongly associated with several cardiovascular risk markers and events. Selection of our books indexed in the book citation index in web of. This assists with the prediction of risk caused by the thickening, or hardening, of the arteries caused by the buildup of plaque. Lppla 2 is an enzyme that can assess the amount of inflammation in your arteries due to a buildup of cholesterol. The plasma biomarkers lipoproteinassociated phospholipase a2 lppla2 activity and mass, proneurotensin, and crp, were studied in.
Whereas the first activity may be considered antiatherogenic, the prevailing consensus is that lp pla2 is positively associated with coronary disease. The present longitudinal prospective study suggests that elevation of plasma lppla 2 activity, lppla 2 mass, and crp, are all markers of subclinical disease susceptibility long time before diagnosis of pad. Pdf lipoproteinassociated phospholipase a2 lppla2 activity. Lppla2 activity top compared with bottom tertile, but not elevated lppla2 mass, increased risk for incident cvd. The plac test is a blood test used to measure serum activity of lipoproteinassociated phospholipase a2 lp pla2, an enzyme that breaks down oxidized lowdensity lipoprotein in the vascular wall. Measurement of lipoproteinassociated phospholipase a2 lp.
All requisition forms received on or after monday, may 23 rd requesting an lp pla 2 test will. Therefore, increased lp pla2 activity in the plasma of hd patients is likely due to enhanced secretion from macrophages. Lipoproteinassociated phospholipase a2 test request a test. There was a moderate agreement between levels of lp pla 2 activity and mass e. Although lppla2 activity correlates with lppla2 mass, the risk of ischemic stroke with lppla2 activity and mass is inconsistent. Lppla 2 activity is to be used in conjunction with clinical evaluation and patient risk assessment as an aid in predicting risk of coronary heart disease chd in patients with no prior history of cardiovascular events. In study participants assigned placebo, lppla2 activity p0.
Lp pla2 activity and mass each show continuous associations with risk of coronary heart disease, similar in magnitude to that with nonhdl cholesterol or systolic blood pressure in this population. Lp pla2 is an enzyme which is usually bound to ldl, often called the bad cholesterol, in the blood and plays a role in the inflammation of blood vessels. Lipoproteinassociated phospholipase a2 lppla2its a mouthful, but for the sake of your heart, its a good idea to get to know it. The possibility of reducing the lp pla2 mass level using simvastatin monotherapy and combination therapy with ezetimibe author links open overlay panel sofia vladimirovna miklishanskaya b tatyana n. Furthermore, we measured total lp pla2 mass and activity in plasma, not the mass or activity associated with ldl or hdl. At baseline, levels of lppla2 mass and activity had a moderate correlation both with each other and ldl. Such assay modification significantly improves the correlation between the plac mass and plac activity tests. The lp pla2 plac test is cleared by the fda to help assess risk for vascular events.
The iplaq test for lp pla2 is manufactured by technopath clinical diagnostics. Elevated baseline lppla2 levels, detected either by activity or mass, are associated with increased stroke risk. The aim of this study is to establish lipoproteinassociated phospholipase a2 lp pla2 reference intervals ris in healthy chinese han adults as a clinical diagnostic indicator according to the clinical and laboratory standards institute clsi c28a3 guidelines. Lipoproteinassociated phospholipase a 2 lppla 2 also known as plateletactivating factor acetylhydrolase pafah is a phospholipase a 2 enzyme that in humans is encoded by the pla2g7 gene. Lp pla2 concentration mass when the lp pla2 activity test is resulted. Elevated lppla 2 levels add prognostic information to the. The lipoproteinassociated phospholipase a2 lp pla2 plac test is typically used to assess a persons risk for certain types of cardiovascular disease as well as events like a heart attack. Cytosolic phospholipase a2 assay kit ab3090 can be used to determine the activity of cytosolic phospholipase a2 cpla2 in purified preparations, cell cultures, or tissue homogenates. Omega3 fats have been implicated in reducing inflammation associated with cvd. Lpa is an ldl particle with a corkscrew protein attached high levels can increase your risk for heart attacks and strokes diet and exercise have no significant affect on lowering abnormal values specific medications can lower lpa levels in some patients a high level of lpa can be genetic family members may consider. Lp pla2 activity the plac test measures lp pla2 activity quantitatively. Lp pla2 mass and activity were measured by the enzymelinked immunosorbent assay and by a colorimetric method, respectively, and compared among 63 multiple sclerosis ms patients and 47 agematched healthy controls hcs. Less than 20% is associated with highdensity lipoprotein hdl. The association between lipoproteinassociated phospholipase a2 lp pla2 and stroke risk is inconsistent.
Lp pla2 is found in high concentration in atherosclerotic plaques that are ready to rupture, causing heart attack or stroke. Ala significantly decreased the oxldl, total lppla2 mass, apobassociated lppla2, and percent of apobassociated lppla2 and triglyceride and increased the percent of hdllppla2 compared with the placebo group but had no significant effect on hdllppla2 mass, apo a1, lipid profiles, and glycemic indices. Plac test for lppla2 activity to predict coronary heart. Lipoproteinassociated phospholipase a aha journals. Moreover, patients with higher lppla2 mass showed more sever icas and had more intracranial arterial lesions. Lipoproteinassociated phospholipase a2 an overview. Plac test for lppla2 activity indications for use describe the plac test for lppla2 activity is an enzyme assay for the in vitro quantitative determination of lppla2 lipoproteinassociated phospholipase a2 activity in edtaplasma and serum on automated clinical chemistry analyzers. This enzyme resides mainly in ldl particles in plasma. The plac test for lp pla2 activity is an enzyme assay for the in vitro quantitative determination of lp pla2 lipoproteinassociated phospholipase a2 activity in edta plasma and serum on automated clinical chemistry analyzers.
Pla 2 levels while also determining the relationship between changes in ldl. Lipoproteinassociated phospholipase a2 health encyclopedia. Lppla2 activity letter to customers for external release. All requisition forms received on or after monday, may 23 rd requesting an lppla 2 test will. Use of this assay with preparations containing more than one type of pla2 will result in the measurement of total pla2 activity rather than cpla2 alone. Evaluation of lipoproteinassociated phospholipase a2 in. This is the main cause of the discordance and poor correlation between the plac mass and activity tests.
Sep 14, 2010 lppla2 is an enzyme that causes hydrolysis of oxidized ldl in the intima generating proinflammatory mediators and a variety of inflammatory stimuli associated with atherosclerosis. Guideline for management of dyslipidemia and prevention of atherosclerosis by the american association of clinical endocrinologists 2012. Plasma lipoproteinassociated phospholipase a 2 activity. Test for measuring the lppla2 mass concentration 2003 and plac. This test measures the function of lipoproteinassociated phospholipase a2 lp pla2, an inflammatory marker critical in ruptureprone plaque formation. Increased levels of lp pla2 are associated with cardiac disease, and may contribute to atherosclerosis. Lppla 2, or lipoproteinassociated phospholipasea 2, measures disease activity within the artery wall below the collagen or calcified cap due to the activation of macrophages. Lp pla2 levels in 763 healthy chinese han subjects 392 males and 371 females were determined by colorimetric analysis and the. The lppla2 mass level reduction was 45% in the combination treatment group versus 38% in the monotherapy group p 0. Plasma lipoproteinassociated phospholipase a 2 activity in. The beneficial effects of alpha lipoic acid supplementation on lp pla2 mass and its distribution between hdl and apobcontaining lipoproteins in type 2 diabetic patients. The effect of statin therapy on lipoprotein associated.
This study reported the predictive ability of lp pla2 levels for cvd after adjustment for traditional cardiac risk factors. Lp pla 2 activity is to be used in conjunction with clinical evaluation and patient risk assessment as an aid in predicting risk of coronary heart disease. Lipemic samples are cause of analytical errors and present challenges for laboratories. The lppla 2 activity test can be performed at the same time your medical provider runs other tests, such as a cholesterol test, to determine if you are at increased risk for heart disease or stroke. Lppla2 is an enzyme produced by the body in response to inflammation in the arteries. More recently, however, increasing numbers of studies have reported an association between lppla2 and.
Human pla2g7pafahlppla2 quantikine elisa kit dplg70. Mar 05, 2015 the plac tests for lp pla2 are the only blood tests that measure the concentration elisa or the enzymatic activity activity of lp pla2, a vascularspecific inflammatory marker critical in the. We conducted a metaanalysis to determine whether elevated lp pla2 is a risk factor for stroke. Describes how the lipoproteinassociated phospholipase a2 lp pla2 test is used, such as to help determine risk of developing cardiovascular disease, when the lp pla2 test is ordered, and what the results of an lp pla2 test might mean. Initial evidence for this came largely from the west of scotland coronary prevention study group woscops in which lp pla2 was compared among 580 cases and 1160 agematched controls. This study examines the ability of lifestyle modification diet and exercise and combination lipid therapy to reduce lp. Lppla2 mass and activity were measured in 5 healthy controls and also in stroke patients treated with tpa at baseline n 99 and serially thereafter n 34 by means of the plac test at an automated olympus analyzer and by a colorimetric activity method diadexus. Associations of lppla 2 mass and activity are not exclusive to vascular outcomes, and the vascular associations depend at least partly on lipids. Detection of human pla2g7pafahlp pla2 by western blot. Higher levels of lipoprotein associated phospholipase a2. The plac test for lp pla 2 activity is an enzyme assay for the in vitro quantitative determination of lp pla 2 lipoproteinassociated phospholipase a2 activity in edta plasma and serum. Lipoproteinassociated phospholipase a2 mass and activity and. When comparing the two tactics lipidlowering therapy has revealed that the lppla2 mass level, total cholesterol and ldlc levels decreased to a greater extent in the combination therapy group than in the monotherapy group.
The snps identified in pla2g7 had modest effects on the levels of lp pla2 mass or activity and would be expected to have even smaller effects on risk for development of chd. A member of the a2 phospholipase superfamily, the enzyme lipoproteinassociated phospholipase a2 lp pla2, is involved in atherogenic processes. We conducted a crosssectional study including 1,374 chinese adults recruited from 2010 to 2011, aiming to evaluate the relationship between lp. Lppla2 activity and mass and crp are associated with. Association of lipoproteinassociated phospholipase a2.
Lppla2 mass or activity were found to predict cv events also in patients with coronary artery disease cad 24, 25, including survivors of. This test is a blood test that measures the level of lp pla2 lipoproteinassociated phospholipase a2, an enzyme associated with the inflammation of arteries. Circulating levels of lppla2 mass and activity are an independent risk factor for cardiovascular events. Lp pla2 is an enzyme produced by the body in response to inflammation in the arteries. Plac test for lppla2 activity blood test life extension. Lppla2 blood test, a marker for vascular inflammation. Effects of lipoproteinassociated phospholipase a2 on. Clinical significance of lp pla2 lp pla2 levels have been shown to predict adverse cardiacrelated events in both patients with stable. The lppla2 test is used for assessing cardiovascular risk. Plac lp pla 2 activity test plac lp pla 2 mass test enzo test code 6279 remains the same 6279 remains the same test name plac test for lp pla2 activity plac test for lp pla2 mass specimen collection serum. It has been shown that both lppla2 mass and activity are higher in t2dm than in individuals without diabetes,14,15 and that a high lppla2. Lp pla2 activity helps predict whether youre at risk for a cardiac event.611 1200 1071 162 1398 1082 543 68 887 1685 1641 764 85 425 1435 94 986 655 160 791 171 1239 28 837 1418 287 1376 396 1081 1358 470 1410 337 391 706