title: Effects of LDL-immunoapheresis on plasma concentrations of vitamin E and carotenoids in patients with familial hypercholesterolemia.
abstract: Recently very potent extracorporeal cholesterol-lowering treatment options have become available for patients with hypercholesterolemia. LDL immunoapheresis treatment selectively removes LDL and lipoprotein(a) from the circulation. Since LDL is the major carrier of lipophilic antioxidants in plasma, the purpose of the present study was to assess the effects of a single LDL apheresis treatment on plasma concentrations of tocopherols (alpha- and gamma-tocopherol) and carotenoids (alpha- and beta-carotene, zeaxanthin, cryptoxanthin, canthaxanthin, lycopene, and retinol). Plasma antioxidant concentrations were determined by HPLC in 7 patients with familial hypercholesterolemia before and after LDL immunoapheresis treatment. Plasma concentrations of both alpha- and gamma-tocopherol and the different carotenoids were significantly reduced by LDL apheresis. However, when standardized for cholesterol to adjust for cholesterol removal, alpha- and gamma-tocopherol, retinol, and the more polar carotenoids lutein and zeaxanthin increased in response to apheresis treatment, while the more unpolar carotenoids such as beta-carotene and lycopene did not change. These data demonstrate that a single LDL immunoapheresis treatment affects tocopherols and individual carotenoids differently. This may be explained by differences in chemical structure and preferential association with different lipoproteins. These results further imply that tocopherols, lutein, zeaxanthin, and retinol, are associated in part with lipoproteins and other carriers such as retinol-binding protein that are not removed during apheresis treatment.
authors.affiliation: Department of Internal Medicine V, Department of Diabetes, Metabolism and Rheumatology, Wilhelminenspital, Vienna.
authors.forename: Edmund
authors.initials: E
authors.lastname: Cauza
authors.forename: Martin
authors.initials: M
authors.lastname: Jansen
authors.forename: Ulrike
authors.initials: U
authors.lastname: Resch
authors.forename: Attila
authors.initials: A
authors.lastname: Dunky
authors.forename: Kurt
authors.initials: K
authors.lastname: Derfler
authors.forename: Brigitte M
authors.initials: BM
authors.lastname: Winklhofer-Roob
authors.forename: Karam
authors.initials: K
authors.lastname: Kostner
mesh_terms: D000328:Adult; D000975:Antioxidants / Q000494:pharmacology; D001781:Blood Component Removal / Q000379:methods*; D016644:Canthaxanthin / Q000097:blood; D002338:Carotenoids / Q000097:blood*; D002784:Cholesterol / Q000378:metabolism; D002851:Chromatography, High Pressure Liquid; D065366:Cryptoxanthins; D004492:Edetic Acid / Q000494:pharmacology; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood* / Q000276:immunology / Q000628:therapy*; D000077276:Lycopene; D008297:Male; D008875:Middle Aged; D024505:Tocopherols / Q000097:blood; D014801:Vitamin A / Q000097:blood; D014810:Vitamin E / Q000097:blood*; D024341:Xanthophylls; D065146:Zeaxanthins; D024502:alpha-Tocopherol / Q000097:blood; D019207:beta Carotene / Q000031:analogs & derivatives* / Q000097:blood; D024504:gamma-Tocopherol / Q000097:blood
chemical_list: D000975:Antioxidants; D065366:Cryptoxanthins; D024341:Xanthophylls; D065146:Zeaxanthins; D019207:beta Carotene; D014801:Vitamin A; D014810:Vitamin E; D002338:Carotenoids; C041635:alpha-carotene; D016644:Canthaxanthin; D024504:gamma-Tocopherol; D002784:Cholesterol; D004492:Edetic Acid; D024502:alpha-Tocopherol; D024505:Tocopherols; D000077276:Lycopene