[H.E.L.P. apheresis and oxidative stress].
LDL apheresis according to the H.E.L.P. procedure is used to treat severe hypercholesterolemia in patients with coronary artery disease (CAD). It has been argued that either hypercholesterolemia or extracorporeal treatment may enhance oxidative stress. The balance between antiand pro-oxidative agents during H.E.L.P. apheresis was investigated by several groups. An increased resistance of LDL to oxidative modification after H.E.L.P. treatment is the leading result of these investigations.We studied the influence of a single H.E.L.P. apheresis on plasma concentrations of lipid peroxidation parameters in patients with heterozygous familiar hypercholesterolemia and advanced CAD enrolled in a chronic apheresis program once a week. Single H.E.L.P. apheresis reduced plasma concentrations of oxidized LDL and malondialdehyde without having an influence on cellular Cu/Zn superoxide dismutase (Cu/ZnSOD). The antioxidative serum capacity declined to some degree after apheresis whereas plasma concentration of 8-isoprostan- PGF2 alpha increased.In H.E.L.P. apheresis, the antioxidative effects prevail. Oxidation of lipids and severe modification of enzymatic and non-enzymatic antioxidants during extracorporeal circulation do not counterbalance the benefit of LDL reduction.
Pulawski
E
E
Herz- und Diabeteszentrum NRW, Kardiologische Klinik, Georgstr. 11, 32545 Bad Oeynhausen, Germany.
Mellwig
K-P
KP
Horstkotte
D
D
D000925:Anticoagulants / Q000627:therapeutic use; D001781:Blood Component Removal / Q000379:methods*; D011232:Chemical Precipitation; D008078:Cholesterol, LDL / Q000097:blood* / Q000302:isolation & purification*; D003324:Coronary Artery Disease / Q000209:etiology / Q000517:prevention & control*; D005112:Extracorporeal Circulation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000150:complications / Q000628:therapy*; D015227:Lipid Peroxidation; D008077:Lipoproteins, LDL / Q000097:blood / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D016896:Treatment Outcome
D000925:Anticoagulants; D008078:Cholesterol, LDL; D008077:Lipoproteins, LDL; D006493:Heparin