Long-term therapeutic efficacy of lipoprotein apheresis on circulating oxidative stress parameters--A comparison of two different apheresis techniques.
BACKGROUND
A chronic lipoprotein apheresis therapy leads to an expressed reduction in the incidence of cardiovascular events in high-risk patients. In addition to the elimination of atherogenic lipoproteins such as LDL and lipoprotein(a), an antioxidative effect of lipoprotein apheresis has been suspected.


OBJECTIVE
We investigated long-term biochemical effects in sixteen patients undergoing lipoprotein apheresis - lipid filtration (LF, n = 7) or dextran sulfate adsorption (DSA, n = 9). Systemic oxidative stress markers (blood phagocyte chemiluminescence, levels of oxidized LDL and antioxLDL antibodies) were examined at the 1st, 40th and 80th apheresis sessions.


RESULTS
In DSA patients, the 80th apheresis session was associated with significantly higher LDL cholesterol removal and lower HDL cholesterol deprivation as compared to LF patients. In contrast to LF patients, DSA patients showed a long-term progressive decrease in circulating oxidant generating activity as evaluated by whole blood chemiluminescence (p < 0.05). Moreover, a single LF apheresis session was associated with higher systemic generation of reactive oxygen species over time.


CONCLUSIONS
Compared to LF, long-term DSA apheresis is associated with a gradual reduction of circulating oxidative burden and may be considered a beneficial molecular mechanism of this technique.
Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany. Electronic address: Steffi.Kopprasch@uniklinikum-dresden.de.
Steffi
S
Kopprasch
Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.
Stefan R
SR
Bornstein
Institute of Clinical Chemistry and Laboratory Medicine, University Hospital Carl Gustav Carus, Dresden, Germany.
Sybille
S
Bergmann
Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.
Juergen
J
Graessler
Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.
Ulrich
U
Julius
D000368:Aged; D001323:Autoantibodies / Q000097:blood; D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000379:methods*; D008078:Cholesterol, LDL / Q000097:blood; D016264:Dextran Sulfate / Q000627:therapeutic use; D005260:Female; D005374:Filtration; D006801:Humans; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D006950:Hyperlipidemia, Familial Combined / Q000097:blood / Q000175:diagnosis / Q000276:immunology / Q000628:therapy*; D007163:Immunosorbent Techniques; D017270:Lipoprotein(a) / Q000097:blood; D008074:Lipoproteins / Q000097:blood* / Q000276:immunology; D008077:Lipoproteins, LDL / Q000097:blood; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D010586:Phagocytes / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome
D001323:Autoantibodies; D015415:Biomarkers; D008078:Cholesterol, LDL; D017270:Lipoprotein(a); D008074:Lipoproteins; D008077:Lipoproteins, LDL; C099252:oxidized low density lipoprotein; D016264:Dextran Sulfate
Lipoprotein apheresis; Long-term biochemical effects; Systemic oxidative stress