Effect of low-density lipoprotein apheresis on circulating endothelial progenitor cells in familial hypercholesterolemia.
BACKGROUND
Long-term treatment with low-density lipoprotein (LDL) apheresis (LA) has been shown to reduce the incidence of cardiovascular events in patients affected by familial hypercholesterolemia (FH). Data from experimental studies suggest that circulating endothelial progenitor cells (EPCs) can repair the vascular lesions caused by atherosclerosis. Since a reduction of these cells has been demonstrated to predict atherosclerosis progression, the aim of this study was to verify whether LA can increase the percentage of EPCs.


METHODS
In 15 patients affected by FH periodically treated with LA, the percentage of EPCs was determined before and after performing LA, and compared with the values of 15 control subjects and 15 hypercholesterolemic patients treated with statins.


RESULTS
Significant differences were found in FH patients between the pre-apheresis percentages of CD34+/KDR+, defined as EPCs by a wide consensus of opinion, and the values found 24 h after the procedures (0.00868 +/- 0.003 vs. 0.01009 +/- 0.002%, p < 0.005). Instead, the percentages of CD34+/KDR+/CD133+, considered as an immature subset of EPCs, remained substantially unchanged. However, a significant reduction in the percentage of EPCs was observed in both patient groups as compared to the controls, at all the assessment times.


CONCLUSIONS
In the short-term LA seems to stimulate mobilization of CD34+/KDR+ cells. Hypercholesterolemic patients show a lower percentage of EPCs than controls. There were no differences in the EPCs percentages between the 2 patients groups, despite the fact that LDL cholesterol levels were higher in the group undergoing LA.
Ramunni
Alfonso
A
Department of Internal and Public Medicine, University of Bari, Italy. a.ramunni@nephro.uniba.it
Brescia
Paola
P
Dambra
Porzia
P
Capuzzimati
Laura
L
Ria
Roberto
R
De Tullio
Giacoma
G
Resta
Francesco
F
Russi
Gianpaolo
G
Vacca
Angelo
A
Coratelli
Pasquale
P
D000328:Adult; D001781:Blood Component Removal / Q000379:methods*; D016022:Case-Control Studies; D002452:Cell Count; D008078:Cholesterol, LDL / Q000097:blood; D042783:Endothelial Cells; D005260:Female; D019650:Hematopoietic Stem Cell Mobilization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D006938:Hyperlipoproteinemia Type II / Q000628:therapy*; D008077:Lipoproteins, LDL / Q000302:isolation & purification*; D008297:Male; D008875:Middle Aged; D013234:Stem Cells; D013997:Time Factors
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL