title: Complement profile and activation mechanisms by different LDL apheresis systems.
abstract: Extracorporeal removal of low-density lipoprotein (LDL) cholesterol by means of selective LDL apheresis is indicated in otherwise uncontrolled familial hypercholesterolemia. During blood-biomaterial interaction other constituents than the LDL particles are affected, including the complement system. We set up an ex vivo model in which human whole blood was passed through an LDL apheresis system with one of three different apheresis columns: whole blood adsorption, plasma adsorption and plasma filtration. The concentrations of complement activation products revealed distinctly different patterns of activation and adsorption by the different systems. Evaluated as the final common terminal complement complex (TCC) the whole blood system was inert, in contrast to the plasma systems, which generated substantial and equal amounts of TCC. Initial classical pathway activation was revealed equally for both plasma systems as increases in the C1rs-C1inh complex and C4d. Alternative pathway activation (Bb) was most pronounced for the plasma adsorption system. Although the anaphylatoxins (C3a and C5a) were equally generated by the two plasma separation systems, they were efficiently adsorbed to the plasma adsorption column before the "outlet", whereas they were left free in the plasma in the filtration system. Consequently, during blood-biomaterial interaction in LDL apheresis the complement system is modulated in different manners depending on the device composition.
authors.affiliation: Coronary Care Unit, Division of Internal Medicine, Nordland Hospital, Bodø, Norway. anders.w.hovland@gmail.com
authors.forename: Anders
authors.initials: A
authors.lastname: Hovland
authors.forename: Randolf
authors.initials: R
authors.lastname: Hardersen
authors.forename: Erik Waage
authors.initials: EW
authors.lastname: Nielsen
authors.forename: Terje
authors.initials: T
authors.lastname: Enebakk
authors.forename: Dorte
authors.initials: D
authors.lastname: Christiansen
authors.forename: Judith Krey
authors.initials: JK
authors.lastname: Ludviksen
authors.forename: Tom Eirik
authors.initials: TE
authors.lastname: Mollnes
authors.forename: Knut Tore
authors.initials: KT
authors.lastname: Lappegård
mesh_terms: D000042:Absorption; D000327:Adsorption; D001781:Blood Component Removal; D003167:Complement Activation; D005260:Female; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000628:therapy; D008077:Lipoproteins, LDL / Q000097:blood / Q000302:isolation & purification*; D008297:Male
chemical_list: D008077:Lipoproteins, LDL