Pregnancy-Associated Plasma Protein-A (PAPP-A) is a zinc-binding metalloproteinase protein
produced by placental syncytio-trophoblasts and secreted into the maternal circulation where its concentration
progressively increases until term. In recent years, PAPP-A has been studied for its potential involvement
in cardiovascular (CV) disease. However, all those studies did not provide a clear view to
identify the pathophysiological links between PAPP-A plasma levels and the occurrence of CV events. In
this review, starting from a complete description of PAPP-A structure and biology, we present an updated
overview of experimental as well as clinical evidence on the role of this metalloproteinase in CV disease.
Finally, we discuss possible therapeutic approaches to antagonize its potential detrimental CV effects.
Keywords: Atherosclerosis, cardiovascular disease, insulin-like growth factor binding proteins, pregnancy-associated plasma
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