The Role Of Lipoprotein(a) In The Progression Of Atherosclerosis In Patients With End-stage Renal Disease

Objective To explore the role of lipoprotein(a)(Lpa)in the progression of atherosclerosis(AS)in end-stage renal disease(ESRD)and further investigate its potential mechanism mediated by CXC chemokine ligand 16(CXCL16)and low density lipoprotein receptor(LDLr).Methods 46 ESRD patients were divided into control group(Lpa<300mg/l,n=23)and high concentration of Lpa group(Lpa?300mg/l,n=23)according to plasma Lpa level.Biochemical indexes and lipid profile of patients were measured.Surgically removed tissues from the radial arteries of patients receiving arteriovenostomy were used in the experiments for preliminary evaluation of AS.Hematoxylin-eosin(HE)and Filipin staining were used to observe foam cell formation.Protein expressions of Lpa,CXCL16,and LDLr were detected by immunohistochemistry staining and immunofluorescence staining.Results There are more foam cell formation and cholesterol accumulation in the arteries of patients in high concentration of Lpa group when compared with the control.Meanwhile,the expressions of Lpa,CXCL16,and LDLr were significantly increased in the arteries of patients in high concentration of Lpa group.Correlation analysis shows that the protein expressions of Lpa(r=0.72,P<0.01),LDLr(r=0.49,P<0.01)and CXCL16(r=0.64,P<0.01)in arteries of ESRD patients are positively correlated with plasma Lpa level.Further analysis shows that the co-expression of Lpa and LDLr is increased in high concentration of Lpa group,as well as the co-expression of Lpa and CXCL16.Conclusions High plasma Lpa level contributes to the progression of AS in ESRD by inducing the Lpa accumulation.LDLr and CXCL16 could be the main lipoproteins by which Lpa enters the cells of arteries.