Changes in lipoprotein(a), LDL-cholesterol and apolipoprotein B in homozygous familial hypercholesterolaemic patients treated with dextran sulfate LDL-apheresis.
We evaluated the effect of periodical treatment with LDL-apheresis by adsorption to dextran sulfate (Liposorber LA-15) on several aspects related to LDL and Lipoprotein(a) metabolisms, in three homozygous familial hypercholesterolaemic patients with LDL receptor deficiency. The dextran sulfate columns retained apolipoprotein B-containing particles with high affinity and capacity, in such a way that the treatment of a volume of plasma equivalent to three times the patient plasma volume resulted in an 85% decrease of circulating LDL-cholesterol and Lipoprotein(a). The continuous treatment with LDL-apheresis was highly beneficial for these patients since an average plasma concentration lower than 200 mg dl-1 for LDL-cholesterol, and lower than 25 mg dl-1 for Lipoprotein(a) could be achieved by treating the patients once a week. After each apheresis treatment, plasma concentrations of these metabolites progressively returned to the pretreatment, steady-state, levels. The analysis of the rates of return allowed us to estimate the fractional catabolic rates. FCRs of LDL-cholesterol were 0.052, 0.049 and 0.047 pools day-1, and those of apolipoprotein B, 0.065, 0.045 and 0.050 pools day-1 in the three subjects, respectively. These values are much lower than those in normolipidaemic individuals as observed by others, and are in accordance with the LDL-receptor deficiency condition of our patients. Two of them had highly elevated Lipoprotein(a) plasma concentrations, and their FCRs of Lipoprotein(a) were calculated to be 0.112 and 0.066 pools day-1.(ABSTRACT TRUNCATED AT 250 WORDS)
Lasunción
M A
MA
Unidad de Dislipemias, Hospital Ramón y Cajal, Madrid, Spain.
Teruel
J L
JL
Alvarez
J J
JJ
Carrero
P
P
Ortuño
J
J
Gómez-Coronado
D
D
D000328:Adult; D001055:Apolipoproteins B / Q000032:analysis*; D001781:Blood Component Removal; D002648:Child; D008078:Cholesterol, LDL / Q000097:blood*; D016264:Dextran Sulfate; D005260:Female; D006720:Homozygote; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000628:therapy*; D017270:Lipoprotein(a) / Q000097:blood*; D008297:Male; D011973:Receptors, LDL / Q000172:deficiency; D012044:Regression Analysis
D001055:Apolipoproteins B; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D011973:Receptors, LDL; D016264:Dextran Sulfate