Effects of heparin-mediated extracorporeal low-density lipoprotein precipitation beyond lowering proatherogenic lipoproteins--reduction of circulating proinflammatory and procoagulatory markers.
In addition to hypercholesterolemia, proinflammatory and prothrombotic markers have been suggested to play an important role in atherogenesis. We examined whether heparin-mediated extracorporeal low-density lipoprotein precipitation (HELP) therapy modulates the circulating levels of proinflammatory and prothrombotic markers. Twenty-two coronary heart disease (CHD) patients undergoing regular HELP-apheresis (18 males, 4 females, mean age 57.3 +/- 10.9 years) were enrolled in this study. A single HELP therapy treatment significantly decreased the circulating levels of high sensitivity C-reactive protein (hs-CRP), soluble vascular adhesion molecule-1 (sVCAM-1), soluble E-selectin, lipopolysaccharide binding protein (LBP), endothelin-1 (ET-1), and monocyte chemoattractant protein-1 (MCP-1) on average by 67, 37, 24, 27, 24, and 15%, respectively. Prothrombotic factors including fibrinogen, tissue factor (TF), soluble CD40 ligand (sCD40L), and homocysteine were decreased by 66, 27, 16, and 22%, respectively. In accordance with previous studies HELP therapy reduced total cholesterol, low density lipoprotein (LDL) cholesterol, and Lp(a) mass by 50, 61, and 62%, respectively. Our data suggest that simultaneous reduction of proinflammatory and prothrombotic factors together with atherogenic lipoproteins by HELP-apheresis may contribute to improvement of endothelial dysfunction and thereby inhibit progression of atherosclerotic lesions and stabilize the existing plaque.
Wang
Ying
Y
Institute of Clinical Chemistry, University Hospital Grosshadern, Marchioninistrasse 15, 81377 Munich, Germany.
Blessing
Frithjof
F
Walli
Autar K
AK
Uberfuhr
Peter
P
Fraunberger
Peter
P
Seidel
Dietrich
D
D001161:Arteriosclerosis / Q000097:blood / Q000517:prevention & control; D001779:Blood Coagulation Factors / Q000032:analysis*; D001781:Blood Component Removal; D002097:C-Reactive Protein / Q000032:analysis; D019013:CD40 Antigens / Q000097:blood; D015815:Cell Adhesion Molecules / Q000097:blood; D005260:Female; D006710:Homocysteine / Q000097:blood; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications / Q000628:therapy*; D018836:Inflammation Mediators / Q000097:blood*; D008077:Lipoproteins, LDL / Q000097:blood*; D008297:Male; D008875:Middle Aged
D001779:Blood Coagulation Factors; D019013:CD40 Antigens; D015815:Cell Adhesion Molecules; D018836:Inflammation Mediators; D008077:Lipoproteins, LDL; D006710:Homocysteine; D002097:C-Reactive Protein