(Onscreen Text) What killed Mona Lisa?
Is the woman we know as Mona Lisa, from the painting by Leonardo da Vinci truly happy?
On the one hand, some speak of the mysterious smile.
On the other, upon closer inspection, it’s difficult to claim that she’s jumping for joy.
That’s why many doctors have taken on a closer examination of the portrait.
A bold claim has even been made
that Mona Lisa ultimately fell victim 
to an elevated blood level of cholesterol,
and that it was responsible for her demise.
Vito Franco, professor of anatomical pathology at the University of Palermo,
points to two key pieces of evidence, 
readily available on the painting.
One of them is exceptionally clearly visible in the vicinity of our panting’s heroine’s left eye.
There, the professor notices a xanthoma, a group of nodules directly linked with cholesterol deposits.
A quick glance at the beauty’s right hand
 unveils another problem.
According to the professor 
what we have there is a lipoma,
a benign type of fatty tissue tumor, characterized 
by clusters of fatty deposits that form lumps.
Both problems are directly related 
to elevated cholesterol levels.
Could such a theory be too far-fetched?
Can we really examine a painting, meticulously 
study the details, and diagnose illnesses?
Were it for anybody else – no, 
but Leonardo da Vinci does make it possible.
He was famous for the almost clinical analysis of the external appearance of the subjects of his paintings.
There is a possibility, therefore, that Mona Lisa suffered from an illness we will study in detail today.
Who knows – maybe we’ll discover 
the real „Da Vinci Code"?
If Mona Lisa’s problem was an elevated 
level of cholesterol, we should first consider 
who our opponent is.
And this is the perfect moment 
to make the first vital comment.
The common notion of associating cholesterol with something exclusively negative is a malefic myth.
That’s because cholesterol can be found 
virtually anywhere.
In our bloodstream, but in the membrane
of each of our cells as well.
It precedes the creation of substances extremely important to the human body, including bile acids 
and hormones.
Where, therefore, do we get it from?
Contrary to popular belief, not only our food.
Our liver produces more on its own 
than we deliver in our diet,
so we may make the simplification that it is the liver 
that cholesterol enters our blood from.
Why does it therefore cause trouble?
On its own, it’s not able to gain access to the body’s cells and therefore needs carriers.
It finds such taxis in the form of lipoproteins.
Problems start when we have too many 
low-density lipoproteins, which we colloquially call 
bad cholesterol or LDL.
Its elevated level is harmful.
In what way?
Usually, the biggest problem then is the formation of cholesterol-lipid-calcium deposits in our blood vessels.
And this may sound quite complicated, 
but in real life, it’s quite simple.
It may be compared to a pipe coming out of a sink.
When do problems start?
For example when it’s too narrow or it becomes mechanically blocked by something.
It’s identical in the case of our blood vessels.
If an unwanted substance starts to deposit on their inside, the bore of such a vessel gets drastically smaller.
This will either cause great problems to the flow of blood or, in the far worse case, completely obstruct it.
What could such a state of affairs lead to?
The worse ones possible: 
strokes, which we know so well;
coronary heart disease,
as well as heart attacks.
They are the most prolific killers 
on the World Health Organisation list.
And familial hypercholesterolemia itself radically raises the chance of the occurrence of such a horrible disease.
Problems with cholesterol, and atherosclerosis 
are the results of age-long negligence,
and then all the fatty foods we’ve eaten 
come back to haunt us.
It may also be the fact that our favourite sport 
was laying on the couch.
There is, however, a group of people who still face 
the problem of elevated cholesterol levels,
in spite of zealously adhering to an exemplary diet, having never even tasted lard, 
or training to their hearts’ content.
What’s more, problems with cholesterol can pester 
even the smallest of children.
And the worst thing is that these people are in now way guilty of leading to such a state of affairs.
This is exactly what happens to the victims of the mysterious illness called familial hypercholesterolemia.
In Poland the number of people affected 
by it is estimated at around 200 000.
Less than one percent of them is diagnosed 
and taking part in treatment.
Ninety-nine percent go about their lives not knowing 
of the bomb ticking in their veins and arteries.
The worldwide figure of familial hypercholesterolemia sufferers is anywhere between 14 and 34 million people.
These numbers make a grim impression.
What makes this terrifying illness familial?
Above all else, we must be aware that such 
a label is bona-fide accurate
because familial hypercholesterolemia 
is caused by a genetic defect,
which causes a substantial rise in the level 
of the so-called bad cholesterol, LDL
regardless of our subject’s lifestyle.
What we’re dealing with is passed down 
from generation to generation.
What is the scale of the problem we’re considering?
With a regular person, the level of the bad cholesterol, LDL, in their system shouldn’t exceed 115 mg/dl.
Sufferers face values ranging from 200 to 400 mg/dl.
Such an elevated problem can burden even 
the youngest, most innocent person,
like this teddy bear we see here.
Let’s now return for a second to the question of family.
Take a look at how it works.
There’s Papa Bear and there’s Mama Bear.
The probability of them passing 
familial hypercholesterolemia
on to one of their two sons 
equals as much as 50 percent.
But there’s more.
Because if one of these two sons 
together with their wife
see offspring of their own, there’s also a very high chance of said offspring being sick.
We are not only facing a disease of families, but, more accurately, a disease of whole generations.
And so we reach the true „Da Vinci Code".
The heroine of our painting is reasonably young,
she doesn’t even look obese yet
and still she apparently suffers 
from cholesterol related problems.
That’s why it’s accepted that she suffers from 
familial hypercholesterolemia.
If familial hypercholesterolemia manifests itself through heart attacks, strokes, or, God forbid, premature death,
then we are facing, or, what’s far worse, have been facing, a disease in a very advanced stage.
Diagnosing the illness then is an utter defeat 
to medicine, let’s notfool ourselves.
Untreated familial hypercholesterolemia 
may shorten the lifespan by twenty to thirty years!
The figures are that horrifying.
We are not, however, at a complete disadvantage.
What I am going to need now 
is for you to focus completely,
because the first, and most typical warning sign
is a family history of illnesses like heart attack, stroke, 
or other illnesses of the cardiovascular system,
especially when they concerned young people.
That’s when we should see a huge neon sign saying
“GET YOURSELF CHECKED!”
This is the exact right moment.
People affected by this illness, like the heroine 
of our painting may also display other warning signs.
These include: clusters in the vicinity of tendons on the heels and palms, known as xanthoma tendinosum;
Yellow spots near the eyes – xanthelasma.
These are great clues, but none of them are conclusive.
They are quite rare and not at all decisive 
when making a diagnosis of the illness.
But they’re worth remembering nonetheless.
I’m sitting here at a blood collection facility, 
a little bit worried
because familial hypercholesterolemia is still, unfortunately, a rarely diagnosed condition.
You wonder why?
The answer is simple:
because we rarely get ourselves checked.
A preliminary diagnosis is really quite 
simple and effective.
How can it be performed?
The first step in the fight against 
familial hypercholesterolemia should be a simple 
blood test that evaluates cholesterol levels.
The comprehensive levels, of course, along with the specifics regarding good and bad cholesterol.
Its elevated levels during such a test are readily visible 
in samples taken from several-year-old children.
We’ve made our way to the most significant matter:
What happens when a person suffering from familial hypercholesterolemia is properly diagnosed?
May they then lie down on an operating table, undergo treatment,and reap the benefits of a clean bill of health?
Unfortunately, not.
This is because the condition cannot be fully cured.
Appropriate therapy may be undertaken,
the sufferers lifestyle may be adapted 
to hinder the disease’s advance.
We may postpone the various complications it entails,
or, simply and honestly speaking, 
extend the sufferer’s life.
Up to now, medicine has relied on medications 
that lower bad cholesterol levels.
What’s more, it even resorted to mechanical filtration 
of the blood in order to lower the levels of LDL.
All this time, however, the medical world has been awaiting a breakthrough.
And we may boldly claim one has recently been made.
Scientists have discovered that a protein we carry 
in our body, which goes by the lovely name PCSK9
may be somewhat influenced by us.
Why? Because this protein hinders or altogether stops the removal of bad cholesterol from our body.
But using antibodies, now we may obstruct the endeavours of the protein itself, and as result lower the level of bad cholesterol by even sixty percent.
We also lower the risk of heart attacks or strokes, 
and this is what it’s all about.
This episode was not meant 
to frighten or sadden anyone.
We should, however, 
be aware that statistically speaking,
in a crowd of 100 000 Poles, we will find as many 
as 500 people suffering from this horrible disease.
And the worst part of this is that out of these 
500 people, only 5 (!) are aware of the condition 
they are afflicted by.
So let’s bear in mind that an early diagnosis and quickly begun treatment are a real chance of a longer and better life of the affected person.
And I am fully aware that we will still associate 
Mona Lisa with her mysterious smile.
It would be a good thing if we started associating 
her with a necessity to monitor cholesterol levels.
Because this association may, for a change, 
save somebody’s life.
