Response to Letter Regarding Article, “Proprotein Convertase Subtilisin Kexin Type 9 Promotes Intestinal Overproduction of Triglyceride-Rich Apolipoprotein B Lipoproteins Through Both Low-Density Lipoprotein Receptor–Dependent and –Independent Mechanisms”

In our Circulation article,1 we stated that few studies have addressed the role of proprotein convertase subtilisin/kexin type 9 (PCSK9) in the small intestine and in the metabolism of triglyceride-rich lipoproteins. In their letter, Drs Le May and Cariou point out the omission of 2 references. The first, published by Le May et al2 in 2009, reports that PCSK9−/− mice display reduced postprandial hypertriglyceridemia and apolipoprotein B levels after olive oil gavage and that adenoviral PCSK9 overexpression or targeted shRNA silencing of PCSK9 increased and reduced apolipoprotein B secretion, respectively. In that article, Le May et al2 acknowledge an earlier observation, published by 1 of us (S.R.) in 2005, that apolipoprotein B48 levels are reduced …