Amarin Corp Plc (AMRN)

[jessellivermore]

HK...

The problem with most of these reviews and opinions are they are made by cardiologists and lipidologists and as such they are trying to tell a story based on blood lipid levels when in reality the tale is mainly about what happens in the Eicosanoid system and the major effects are on Systemic Inflammation (SI)...The confusion results from the fact SI is the real puppet master and the lipids are just the puppets...SI pulls the strings..but lipidologists and cardiologists...are surprisingly unaware of this fact..

For example take Type 2 diabetes (T2DM)...The root problem in T2DM is elevated SI..Something medical scientists are very aware of, but clinicians for the most part do not understand..In T2DM elevated SI causes Insulin Resistance (IR) IR is a condition where the insulin becomes less effective at lowering Blood sugar..The end result is the T2DM patient requires higher levels of insulin to control his blood sugar levels..This produces a cascade effect because insulin not only lowers blood sugar..but it also elevates SI..Creating a viscous cycle..More Insulin means higher SI (Systemic Inflammation) levels and that means increase Insulin resistance..

The fact this goes unappreciated was brought out dramatically in the ACCORD clinical trial...One arm of ACCORD attempted to show carefully controlled blood sugar levels (A1Cs) under a certain level would lead to fewer CVD events...This did not happen and to the diabetic community it is still a mystery..Death rates were significantly higher in the control arm (the low A1Cs)...The reason was simple enough if you undertand the the pathophysiology. The culprit here was not the blood sugar it was the insulin..To get the lower blood sugar levels (A1Cs) Patients got more insulin and this increased SI and it was the elevated SI levels that was causing the increased CVD event risk...

The mot important effects of EPA are not related to changes it makes in blood lipids..That is just stupidity..The main reason EPA cuts CVD event risk down is not because if stabilizes the cell membranes (though it does). The major effect of EPA is on the Eicosanoid membrane receptors chiefly the COX and LOX receptors..For an active moiety to interact with these receptors it must have the correct three dimensional structure to fit into the receptors the way the correct key fits into a lock..DHA does not have the correct structure...EPA's effects on blood lipids are mainly effected via the eicosanoid systems effects on SI...

Sorry to say that even Dr. Bhatt who has been a wonderful spokesman for Amarin and Vascepa..does not seem to be comfortable with the SI effects of RPA and tht is a shame...

The legal system tries to simplify the Action of EPA and does a worse job than even medicine does..To argue ten years ago the effects of EPA were obvious is an opinion based on ignorance...I believe you could interview 100 cardiologist and less than 5 would be able lay out how EPA changes blood lipids...Finally in 2011--2012 era..I tried to explain on the ADA forum how EPA could lower CVD events in T2DM...And the upshot ws they accused me of being a shill for Amarin and had me permanently banned from posting on the ADA website...As far as I know..I am still banned...

Obvious..I don't think so...

":>) JL