title: LDL-apheresis improves peripheral arterial occlusive disease with an implication for anti-inflammatory effects.
abstract: Although it is known that LDL-apheresis improves ischemic limb seen in patients with peripheral arterial occlusive disease (PAOD), anti-inflammatory effects are not well known. We studied whether or not serum or plasma levels of high sensitivity C-reactive protein (hsCRP), monocyte chemoatractant protein-1 (MCP-1), or fibrinogen could contribute to favorable effects for ischemic limbs after LDL-apheresis. Twenty-eight patients with PAOD (24 men, 4 women) were enrolled in our study. LDL-apheresis was performed 10 times (treated plasma of 3,000 ml) for 5 weeks. Serum levels of logarithmically transformed values of hsCRP significantly decreased from 3.666 +/- 0.126 to 3.482 +/- 0.139 ng/ml before and after a single session of LDL-apheresis (P < 0.001). Serum levels of MCP-1 decreased from 233 +/- 17.5 to 187 +/- 13.5 pg/ml before and after LDL-apheresis (P < 0.05). Likewise, plasma fibrinogen levels statistically decreased from 196 +/- 9.82 to 159 +/- 9.60 mg/dl (P < 0.001). Overall rates of improvement including foot chillness or numbness, and double folds increase in walking distance were 82.1% 3 months after a completion of LDL-apheresis, while gangrene was only improved 14.3%. Intermittent claudication improved in 53.6%. The favorable actions of LDL-apheresis might include anti-inflammatory effects. To avoid amputation, LDL-apheresis should be applied for patients with PAOD at an early stage of the disease process and may be applicable for patients with atherosclerotic cardiovascular disorders.
authors.affiliation: Department of Nephrology, Kidney & Dialysis Center, Shonan Kamakura General Hospital, Yamazaki Kamakura, Japan. shuzo@shonankamakura.or.jp
authors.forename: Shuzo
authors.initials: S
authors.lastname: Kobayashi
authors.forename: Hidekazkeu
authors.initials: H
authors.lastname: Moriya
authors.forename: Kyouko
authors.initials: K
authors.lastname: Maesato
authors.forename: Kouji
authors.initials: K
authors.lastname: Okamoto
authors.forename: Takayasu
authors.initials: T
authors.lastname: Ohtake
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000097:blood / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D018932:Chemokine CCL2 / Q000097:blood; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006440:Hemofiltration; D006801:Humans; D007249:Inflammation / Q000097:blood; D007511:Ischemia / Q000097:blood / Q000628:therapy; D008077:Lipoproteins, LDL; D008297:Male; D008875:Middle Aged; D016491:Peripheral Vascular Diseases / Q000097:blood / Q000628:therapy*
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D008077:Lipoproteins, LDL; D005340:Fibrinogen; D002097:C-Reactive Protein