Double filtration plasmapheresis maintains normal adhesion molecule levels

Area of Science:

• Cardiovascular Medicine
• Biochemistry
• Medical Technology

Background:

• Elevated plasma levels of soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), and von Willebrand factor (vWF) are associated with peripheral vascular disease, ischemic heart disease, and atherosclerosis progression.
• These molecules, along with thrombomodulin (TM), serve as indicators of endothelial damage.

Purpose of the Study:

• To evaluate the impact of long-term double filtration plasmapheresis (DFPP) on plasma levels of vWF, sICAM-1, sVCAM-1, and TM in patients with familial hypercholesterolemia (FH).
• To assess whether DFPP treatment affects endothelial integrity.

Main Methods:

• Plasma levels of vWF, sICAM-1, sVCAM-1, and TM were measured in 4 FH patients before and after DFPP treatment administered at 2-week intervals over 3 years.
• Comparison of pre- and post-treatment values was performed.

Main Results:

• While plasma vWF activity significantly decreased post-DFPP (158% to 45%), plasma TM levels showed no significant change (3.0 FU/ml to 3.4 FU/ml).
• Average sICAM-1 levels decreased slightly from 221 ng/ml to 197 ng/ml, and sVCAM-1 levels decreased from 601 ng/ml to 486 ng/ml, but these changes were not statistically significant.
• Pre-treatment sICAM-1 and sVCAM-1 levels in FH patients with ischemic heart disease were elevated compared to normal values.

Conclusions:

• Long-term DFPP treatment in FH patients does not appear to cause endothelial damage.
• DFPP may potentially inhibit atherosclerosis progression by removing substances that stimulate sICAM-1 and sVCAM-1 production.