LDL-apheresis reduces P-Selectin, CRP and fibrinogen -- possible important implications for improving atherosclerosis.
Although it is known that LDL-apheresis improves coronary artery stenosis (CAS) as well as ischemic limbs seen in patients with peripheral arterial occlusive disease (PAOD), the underlying mechanisms remain still unknown. LDL-apheresis might exert its favorable action through anti-inflammatory effects. We studied whether or not serum or plasma levels of P-selectin, high sensitivity C-reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1) or fibrinogen could be reduced in patients with PAOD before and after 10 sessions of LDL-apheresis. Sixteen patients (12 patients with hemodialysis, HD) with PAOD were enrolled in the present study. LDL-apheresis was carried out 10 times (treated plasma of 3000 mL) over 5 weeks. Serum levels of P-selectin were significantly reduced from 516 +/- 153 to 290 +/- 52 ng/mL before and after 10-sessions of LDL-apheresis, respectively (P < 0.05). Likewise, serum levels of hsCRP decreased from 9.118 +/- 2.649 to 5.587 +/- 2.445 mg/L (P < 0.01); and plasma fibrinogen levels statistically decreased from 196 +/- 9.82 to 149 +/- 7.97 mg/dL (P < 0.01), whereas serum levels of MCP-1 were not significantly changed. The favorable actions of LDL-apheresis might include anti-inflammatory effects, which could lead to an improvement of CAS and PAOD. Moreover, this intervention might be applicable for patients with atherosclerotic cardiovascular disorders, particularly in patients with HD.
Kobayashi
Shuzo
S
Shonan Kamakura General Hospital, Department of Nephrology and Kidney & Dialysis Center, Yamazaki Kamakura, Japan. shuzo@shonankamakura.or.jp
Oka
Machiko
M
Moriya
Hidekazkeu
H
Maesato
Kyoko
K
Okamoto
Koji
K
Ohtake
Takayasu
T
D000328:Adult; D000368:Aged; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D050197:Atherosclerosis / Q000628:therapy*; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000379:methods*; D002097:C-Reactive Protein / Q000032:analysis; D023921:Coronary Stenosis / Q000628:therapy*; D005260:Female; D005340:Fibrinogen / Q000032:analysis; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008077:Lipoproteins, LDL / Q000097:blood* / Q000302:isolation & purification; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D015415:Biomarkers; D008077:Lipoproteins, LDL; D019007:P-Selectin; D005340:Fibrinogen; D002097:C-Reactive Protein