Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease

Elevated levels of lipoprotein (a) [Lp(a)], an apolipoprotein B particle, are causally linked to atherosclerotic cardiovascular disease (ASCVD). Lp(a) is thought to promote ASCVD through multiple mechanisms, including its effects on cholesterol transport, inflammation, and thrombosis. This study def...

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Main Authors: Robert S. Rosenson, Ashley M. Tate, Olga G. Grushko, Dilna Damodaran, Qinzhong Chen, Michael Boffa, Marlys Koschinsky, Jagat Narula, Sascha N. Goonewardena
Format: Article
Language:English
Published: Elsevier 2025-06-01
Series:Journal of Lipid Research
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Online Access:http://www.sciencedirect.com/science/article/pii/S002222752500080X
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author Robert S. Rosenson
Ashley M. Tate
Olga G. Grushko
Dilna Damodaran
Qinzhong Chen
Michael Boffa
Marlys Koschinsky
Jagat Narula
Sascha N. Goonewardena
author_facet Robert S. Rosenson
Ashley M. Tate
Olga G. Grushko
Dilna Damodaran
Qinzhong Chen
Michael Boffa
Marlys Koschinsky
Jagat Narula
Sascha N. Goonewardena
author_sort Robert S. Rosenson
collection DOAJ
description Elevated levels of lipoprotein (a) [Lp(a)], an apolipoprotein B particle, are causally linked to atherosclerotic cardiovascular disease (ASCVD). Lp(a) is thought to promote ASCVD through multiple mechanisms, including its effects on cholesterol transport, inflammation, and thrombosis. This study defines the mechanisms that integrate Lp(a)-mediated cholesterol accumulation, inflammation, and thrombosis. In this study, we employed systems biology approaches, including proteomics, transcriptomics, and mass cytometry, to define the immune cellular and molecular phenotypes in patients with ASCVD having high and low Lp(a) levels and the molecular mechanisms through which Lp(a) mediates monocyte-driven inflammation and thrombosis. In 64 stable patients with ASCVD (41 with high Lp(a) [median Lp(a) 228.7 nmol/L] and 23 with low Lp(a) [median Lp(a) 17.8 nmol/L]), we found that circulating markers of inflammation (CCL28, IL-17D) and vascular dysfunction (tissue factor [TF]; 6.4 vs. 5.7 normalized protein expression (NPX); P = 0.01) were elevated in patients with high Lp(a) levels compared with those with low Lp(a) levels. Although total monocyte and hsCRP levels were similar between the groups, CD14+ monocytes from patients with ASCVD having an elevated Lp(a) were primed and expressed more TF at baseline and in response to stress. Mechanistically, we found that Lp(a) itself can activate monocytes through Toll-like receptor 2 (TLR2) and nuclear factor kappa B (NFκB) signaling, driving both the induction of TF and TF activity. Overall, these studies are the first to link Lp(a) to monocyte-mediated inflammation and thrombosis. This study demonstrates a novel mechanism through TLR2, NFκB, and monocyte TF by which Lp(a) amplifies immunothrombotic risk.
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spelling doaj-art-3155b05546564b4fa44df8e669a9ab9b2025-08-20T03:32:00ZengElsevierJournal of Lipid Research0022-22752025-06-0166610082010.1016/j.jlr.2025.100820Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular diseaseRobert S. Rosenson0Ashley M. Tate1Olga G. Grushko2Dilna Damodaran3Qinzhong Chen4Michael Boffa5Marlys Koschinsky6Jagat Narula7Sascha N. Goonewardena8Metabolism and Lipids Program, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, USA; For correspondence: Robert S. Rosenson; Sascha N. GoonewardenaDivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Ann Arbor, MI, USADivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Ann Arbor, MI, USADivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Ann Arbor, MI, USAMetabolism and Lipids Program, Mount Sinai Fuster Heart Hospital, Icahn School of Medicine at Mount Sinai, New York, USARobarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, CanadaRobarts Research Institute, Schulich School of Medicine and Dentistry, The University of Western Ontario, London, ON, CanadaMcGovern Medical School, University of Texas Health Sciences Center, Houston, TX, USADivision of Cardiovascular Medicine, Department of Internal Medicine, University of Michigan Ann Arbor, MI, USA; For correspondence: Robert S. Rosenson; Sascha N. GoonewardenaElevated levels of lipoprotein (a) [Lp(a)], an apolipoprotein B particle, are causally linked to atherosclerotic cardiovascular disease (ASCVD). Lp(a) is thought to promote ASCVD through multiple mechanisms, including its effects on cholesterol transport, inflammation, and thrombosis. This study defines the mechanisms that integrate Lp(a)-mediated cholesterol accumulation, inflammation, and thrombosis. In this study, we employed systems biology approaches, including proteomics, transcriptomics, and mass cytometry, to define the immune cellular and molecular phenotypes in patients with ASCVD having high and low Lp(a) levels and the molecular mechanisms through which Lp(a) mediates monocyte-driven inflammation and thrombosis. In 64 stable patients with ASCVD (41 with high Lp(a) [median Lp(a) 228.7 nmol/L] and 23 with low Lp(a) [median Lp(a) 17.8 nmol/L]), we found that circulating markers of inflammation (CCL28, IL-17D) and vascular dysfunction (tissue factor [TF]; 6.4 vs. 5.7 normalized protein expression (NPX); P = 0.01) were elevated in patients with high Lp(a) levels compared with those with low Lp(a) levels. Although total monocyte and hsCRP levels were similar between the groups, CD14+ monocytes from patients with ASCVD having an elevated Lp(a) were primed and expressed more TF at baseline and in response to stress. Mechanistically, we found that Lp(a) itself can activate monocytes through Toll-like receptor 2 (TLR2) and nuclear factor kappa B (NFκB) signaling, driving both the induction of TF and TF activity. Overall, these studies are the first to link Lp(a) to monocyte-mediated inflammation and thrombosis. This study demonstrates a novel mechanism through TLR2, NFκB, and monocyte TF by which Lp(a) amplifies immunothrombotic risk.http://www.sciencedirect.com/science/article/pii/S002222752500080XInflammationlipoproteinsthrombosismonocytestissue factorlipoprotein(a)
spellingShingle Robert S. Rosenson
Ashley M. Tate
Olga G. Grushko
Dilna Damodaran
Qinzhong Chen
Michael Boffa
Marlys Koschinsky
Jagat Narula
Sascha N. Goonewardena
Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
Journal of Lipid Research
Inflammation
lipoproteins
thrombosis
monocytes
tissue factor
lipoprotein(a)
title Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
title_full Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
title_fullStr Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
title_full_unstemmed Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
title_short Lipoprotein (a) integrates monocyte-mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
title_sort lipoprotein a integrates monocyte mediated thrombosis and inflammation in atherosclerotic cardiovascular disease
topic Inflammation
lipoproteins
thrombosis
monocytes
tissue factor
lipoprotein(a)
url http://www.sciencedirect.com/science/article/pii/S002222752500080X
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