Inibitori PCSK-9 e infiammazione in pazienti ad alto richio cardiovascolare

Inibitori PCSK-9 e infiammazione in pazienti ad alto rischio cardiovascolare Inflammation plays an important role in atherosclerosis both in the early stage and in its progression. PCSK-9 is a newly discovered serine protease playing a key role in destroying LDL receptors in liver and thereby controlling the level of LDL in plasma. New monoclonal antibodies capable of binding to PCSK 9 and blocking their interaction with hepatic receptors for LDL were therefore developed. NETs are one of the most recent inflammatory markers used for atherosclerotic vasal damage. The aim of this study is to evaluate the inflammatory response of dyslipidemic patients at high nontarget cardiovascular risk which have been treated with PCSK9 inhibitors in association with statin and compared it to the inflammatory response of a group of patients treated with statin therapy only. The data of our research is taken from a group of 19 patients with high-risk cardio-vascular dyslipidemia. Among these, 13 patients had non-target LDL levels with the highest tolerated statin dose and were treated with statin and PCSK9; while 6 patients had target LDL values with statin therapy alone. Anthropometric measurements such as blood chemistry tests, quantification of NETs formation in neutrophil and its correlation with the elastase release and detecting of some cytokines (IL8 IL10 IL17 IL-1beta and TNFalfa) were determined in all patients. In conclusion in patients already treated with maximal statin doses, it seems that the addition of PCSK9i did not affect the ability of neutrophils to release NETs nor the trend over time of the inflammatory cytokines evaluated. We assume that the inflammatory pattern may have already been intensively modified by statin therapy at high dosages.