Phospholipase A₂ inhibition and atherosclerotic vascular disease: Prospects for targeting secretory and lipoprotein-associated phospholipase A₂ enzymes

Purpose of review: Selective inhibitors of secretory phospholipase A ₂ and lipoprotein-associated phospholipase A₂ are potential candidates for reducing recurrent cardiovascular events in patients with established coronary heart disease (CHD). With the active enrollment of CHD patients into phase III clinical trials with both classes of inhibitors, this article reviews the available experimental animal and human trial evidence that provides the rationale for the development of the phospholipase A2 inhibitors varespladib methyl and darapladib as preventive therapy. Recent findings: Recently completed experimental animal studies, human biomarker data, and vascular imaging studies provide support for proceeding with clinical outcome trials secretory phospholipase A₂ and lipoprotein-associated phospholipase A₂ inhibition. Summary: Both secretory phospholipase A₂ and lipoprotein-associated phospholipase A₂ inhibitors hold promise for the reduction of recurrent cardiovascular events in patients treated with current standards of care. The completion of the ongoing clinical event trials has the potential to provide a new dimension to secondary preventive therapy.