title: Selective apheresis of C-reactive protein: a new therapeutic option in myocardial infarction?
abstract: BACKGROUND
  There is substantial evidence that C-reactive protein (CRP) mediates secondary damage of the myocardium after acute myocardial infarction (AMI). The aim of this animal trial in pigs was to specifically deplete CRP from porcine plasma after AMI and to study possible beneficial effects of the reduced CRP concentration on the infarcted area.
  
  
  METHODS
  Ten pigs received balloon catheter-induced myocardial infarction. CRP was depleted from five animals utilizing a new specific CRP-adsorber, five animals served as controls. The area of infarction was analyzed by cardiovascular magnetic resonance imaging on day 1 and day 14 after AMI. Porcine CRP levels were determined by ELISA.
  
  
  RESULTS
  CRP-apheresis resulted in a mean reduction of the CRP levels up to 48.3%. The area of infarction was significantly reduced by 30 ± 6% (P = 0.003) within 14 days in the treatment group, whereas it increased by 19 ± 11% (P = 0.260) in the controls. Fourteen days after infarction, the infarcted area revealed compact, transmural scars in the controls, whereas animals receiving CRP-apheresis showed spotted scar morphology. In the interventional group, a significantly higher left ventricular ejection fraction (LVEF) was observed after 14 days as compared to the controls (57.6 ± 2.4% vs. 46.4 ± 2.7%; P = 0.007).
  
  
  CONCLUSIONS
  In a pig model for AMI, we observed that selective CRP-apheresis significantly reduces CRP levels and the volume of the infarction zone after AMI. Additionally, it changes the morphology of the scars and preserves cardiac output (LVEF).
authors.affiliation: Department of Nephrology and Internal Intensive Care Medicine, Charité - Universitätsmedizin Berlin, Berlin, Germany.
authors.forename: Ahmed
authors.initials: A
authors.lastname: Sheriff
authors.forename: Ralf
authors.initials: R
authors.lastname: Schindler
authors.forename: Birgit
authors.initials: B
authors.lastname: Vogt
authors.forename: Hassan
authors.initials: H
authors.lastname: Abdel-Aty
authors.forename: Juliane K
authors.initials: JK
authors.lastname: Unger
authors.forename: Christopher
authors.initials: C
authors.lastname: Bock
authors.forename: Frank
authors.initials: F
authors.lastname: Gebauer
authors.forename: Anna
authors.initials: A
authors.lastname: Slagman
authors.forename: Timo
authors.initials: T
authors.lastname: Jerichow
authors.forename: Dörte
authors.initials: D
authors.lastname: Mans
authors.forename: Gülcan
authors.initials: G
authors.lastname: Yapici
authors.forename: Gunnar
authors.initials: G
authors.lastname: Janelt
authors.forename: Malte
authors.initials: M
authors.lastname: Schröder
authors.forename: Rudolf
authors.initials: R
authors.lastname: Kunze
authors.forename: Martin
authors.initials: M
authors.lastname: Möckel
mesh_terms: D000818:Animals; D001781:Blood Component Removal / Q000379:methods*; D002097:C-Reactive Protein / Q000302:isolation & purification* / Q000378:metabolism; D004195:Disease Models, Animal; D005260:Female; D008279:Magnetic Resonance Imaging; D009203:Myocardial Infarction / Q000097:blood* / Q000473:pathology / Q000628:therapy*; D009206:Myocardium / Q000473:pathology; D013318:Stroke Volume; D034421:Sus scrofa
chemical_list: D002097:C-Reactive Protein
keywords: C-reactive protein; apheresis; immunoadsorption; myocardial infarction