I predict a brave new world in which a significant proportion of the population will be receiving pharmacological interventions to optimise the ageing process. #BrainHealth #PreventiveNeurology The following study is a good example of the revolution that genomics has brought to the practice of medicine. The discovery (2003) that gain-of-function mutations in the proprotein convertase subtilisin–kexin type 9 (PCSK9) gene causes autosomal dominant hypercholesterolaemia, and the identification (2005) of loss-of-function mutations in PCSK9 causing lower low-density lipoprotein (LDL) cholesterol levels, led to the PCSK9 pathway becoming a therapeutic target. PCSK9 is a secreted serine protease that binds to the extracellular domain of the LDL receptor and targets the LDL receptor to the lysosomal compartment for degradation. PCSK9 prevents recycling of the LDL receptor to the cell surface, thereby attenuating LDL clearance. PCSK9 circulates in plasma, where it is closel...