LDL apheresis for arteriosclerosis obliterans with occluded bypass graft: change in prostacyclin and effect on ischemic symptoms.
To study the mechanism of efficacy of low-density lipoprotein (LDL) adsorption for arteriosclerosis obliterans (ASO), eight ASO patients without indication for bypass surgery underwent LDL apheresis twice a week for 5 weeks and the change in prostaglandin 12 (PGI2) and thromboxane A2 (TXA2) due to LDL apheresis was measured. The concentration of 6-keto-PGF1alpha, a metabolite of PGI2, in systemic venous blood significantly increased from 10.4 +/- 1.8 to 42.0 +/- 10.6 pg/mL (P<0.05) after one session of LDL apheresis, while no significant change of TXB2, a metabolite of TXA2, was encountered. The ratio of 6-keto-PGF1alpha/TXB2 also rose dramatically from 0.213 +/- 0.044 to 0.522 +/- 0.128 (P<0.05). In five patients, the ischemic clinical symptoms improved and both the concentration of 6-keto-PGF1alpha and the ratio of 6-keto-PGF1alpha/TXB2 increased significantly, whereas in three patients there was no effect on clinical symptoms and neither parameter changed. These results suggest that elevated production of PGI2 from vascular cells due to LDL apheresis might contribute to improvement of ischemic symptoms.
Mii
S
S
Department of Surgery, Nippon Steel Corporation Yawata Works Hospital, Kitakyushu-City, Japan.
Mori
A
A
Sakata
H
H
Nakayama
M
M
Tsuruta
H
H
D000368:Aged; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000628:therapy*; D001781:Blood Component Removal / Q000295:instrumentation / Q000379:methods*; D011464:Epoprostenol / Q000097:blood*; D005080:Exercise Test; D005260:Female; D006083:Graft Occlusion, Vascular / Q000097:blood / Q000628:therapy*; D006801:Humans; D007383:Intermittent Claudication / Q000097:blood / Q000628:therapy; D007511:Ischemia / Q000097:blood / Q000628:therapy*; D007866:Leg / Q000098:blood supply*; D008055:Lipids / Q000097:blood; D008077:Lipoproteins, LDL / Q000097:blood / Q000302:isolation & purification*; D008297:Male; D011379:Prognosis; D013997:Time Factors
D008055:Lipids; D008077:Lipoproteins, LDL; D011464:Epoprostenol