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Health Disparities in Diagnosis and Treatment of Heterozygous Familial Hypercholesterolemia.

J Pediatr

March 2025

Division of Cardiology, Department of Pediatrics, The Children's Hospital of Philadelphia and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania.

Objective: To examine the association of social determinants of health and age at heterozygous familial hypercholesterolemia (HeFH) diagnosis and treatment.

Study Design: We performed a retrospective, single-center study of children with HeFH. Multivariable linear regression models were used to examine the association between Child Opportunity Index (COI) and age at HeFH diagnosis and statin initiation.

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Introduction: Inclisiran, a small interfering RNA (siRNA), reduces the levels of low-density lipoproteins (LDL) in the body by preventing the hepatic synthesis of proprotein convertase subtilisin/kexin type 9 (PCSK9). However, there is limited pooled data regarding the efficacy and safety of inclisiran in patients with hypercholesterolemia.

Methods: PubMed/MEDLINE, Embase and the Cochrane Library were searched by investigators from inception till July 2024 to identify randomised controlled trials (RCTs) that investigated inclisiran in patients with hypercholesterolemia.

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Background: Inborn errors of metabolism (IEMs) are inherited diseases causing significant morbidity and mortality, particularly in childhood. Liver transplantation (LT) can be curative or partially effective for these diseases. LT for IEMs has increased, making IEMs the second most common reason for pediatric LT after biliary atresia.

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PCSK9 Promotes LDLR Degradation by Preventing SNX17-Mediated LDLR Recycling.

Circulation

March 2025

State Key Laboratory of Metabolism and Regulation in Complex Organisms, Hubei Key Laboratory of Cell Homeostasis, College of Life Sciences, TaiKang Center for Life and Medical Sciences, Wuhan University, China. (Y.G., X.L., X.Z., M.L., M.D., Y.W.).

Background: Low-density lipoprotein (LDL) is internalized into cells mainly through LDLR (LDL receptor)-mediated endocytosis. In an acidic endosome, LDLR is released from LDL and recycles back to the cell surface, whereas LDL is left in the endosome and degraded in the lysosome. Circulating PCSK9 (proprotein convertase subtilisin/kexin 9) binds with LDLR and is internalized into the endosome, similar to LDL.

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Atherosclerosis is a systemic disease and involves not only the coronary vessels but also occurs in other vascular beds (e.g., cervical, cerebral, and peripheral vessels), increasing cardiovascular risk.

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