Non-Lipid Effects of PCSK9 Monoclonal Antibodies on Vessel Wall

Figures

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  Figure 1. The role of PCSK9 in inflammation process. PCSK9 induces the expression of VEGF-A and ICAM-1 and, consequently, activates endothelial cells and stimulates monocyte/macrophage migration. The cascade promotes an inflammatory state and the progression of the atherosclerotic process. On the other hand, anti-inflammatory cytokines such as IL-10 attenuate the inflammatory response. PCSK9, proprotein convertase subtilisin/kexin type 9; VEGF-A, vascular endothelial growth factor A; ICAM-1, intracellular adhesion molecule-1; IL, interleukin; TNF-α, tumor necrosis factor-α.

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  Figure 2. The role of PCSK9 in platelets’ activity. High PCSK9 levels enhance platelet activation and reduce platelet responsiveness to acetylsalicylic acid, thus promoting atherosclerotic events. ASA, acetylsalicylic acid.

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  Figure 3. The role of PCSK9 in coagulation and fibrinolysis. PCSK9 induces the production of tissue factor, which is responsible for the activation of the extrinsic coagulation pathway and thrombus formation. TF, tissue factor; PAI-1, plasminogen activator inhibitor-1; F VIII, factor VIII.