title: Effect of low-density lipoprotein apheresis on circulating endothelial progenitor cells in familial hypercholesterolemia.
abstract: 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.
authors.affiliation: Department of Internal and Public Medicine, University of Bari, Italy. a.ramunni@nephro.uniba.it
authors.forename: Alfonso
authors.initials: A
authors.lastname: Ramunni
authors.forename: Paola
authors.initials: P
authors.lastname: Brescia
authors.forename: Porzia
authors.initials: P
authors.lastname: Dambra
authors.forename: Laura
authors.initials: L
authors.lastname: Capuzzimati
authors.forename: Roberto
authors.initials: R
authors.lastname: Ria
authors.forename: Giacoma
authors.initials: G
authors.lastname: De Tullio
authors.forename: Francesco
authors.initials: F
authors.lastname: Resta
authors.forename: Gianpaolo
authors.initials: G
authors.lastname: Russi
authors.forename: Angelo
authors.initials: A
authors.lastname: Vacca
authors.forename: Pasquale
authors.initials: P
authors.lastname: Coratelli
mesh_terms: 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
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008077:Lipoproteins, LDL