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Published on: December 11, 2020
[H.E.L.P. apheresis and oxidative stress]
E Pulawski1, K-P Mellwig, D Horstkotte
1Herz- und Diabeteszentrum NRW, Kardiologische Klinik, Georgstr. 11, 32545 Bad Oeynhausen, Germany.
Insights
H.E.L.P. apheresis reduces oxidative stress in patients with severe hypercholesterolemia and coronary artery disease. This LDL apheresis procedure lowers oxidized LDL and malondialdehyde, prevailing antioxidative effects.
Area of Science:
- Cardiology
- Biochemistry
Background:
- Severe hypercholesterolemia and coronary artery disease (CAD) pose significant health risks.
- The H.E.L.P. apheresis procedure is a treatment for severe hypercholesterolemia in CAD patients.
- Concerns exist regarding oxidative stress induced by hypercholesterolemia or extracorporeal treatments like apheresis.
Purpose of the Study:
- To investigate the balance of pro- and antioxidative agents during H.E.L.P. apheresis.
- To assess the influence of a single H.E.L.P. apheresis session on lipid peroxidation parameters.
- To determine if H.E.L.P. apheresis increases LDL resistance to oxidative modification.
Main Methods:
- Studied patients with heterozygous familial hypercholesterolemia and advanced CAD undergoing chronic weekly apheresis.
- Analyzed plasma concentrations of oxidized LDL, malondialdehyde, and 8-isoprostane PGF2 alpha before and after a single H.E.L.P. apheresis.
- Measured the effect on cellular Cu/Zn superoxide dismutase (Cu/ZnSOD) and overall serum antioxidative capacity.
Main Results:
- A single H.E.L.P. apheresis significantly reduced plasma concentrations of oxidized LDL and malondialdehyde.
- No significant influence was observed on cellular Cu/Zn superoxide dismutase (Cu/ZnSOD) levels.
- Serum antioxidative capacity showed a slight decline, while 8-isoprostane PGF2 alpha plasma concentrations increased post-apheresis.
Conclusions:
- The antioxidative effects of H.E.L.P. apheresis appear to prevail over pro-oxidative factors.
- Lipid oxidation and antioxidant modification during extracorporeal circulation do not negate the benefits of LDL reduction.
- H.E.L.P. apheresis demonstrates a favorable impact on the oxidative stress balance in treated patients.
Abstract:
LDL apheresis according to the H.E.L.P. procedure is used to treat severe hypercholesterolemia in patients with coronary artery disease (CAD). It has been argued that either hypercholesterolemia or extracorporeal treatment may enhance oxidative stress. The balance between antiand pro-oxidative agents during H.E.L.P. apheresis was investigated by several groups. An increased resistance of LDL to oxidative modification after H.E.L.P. treatment is the leading result of these investigations.We studied the influence of a single H.E.L.P. apheresis on plasma concentrations of lipid peroxidation parameters in patients with heterozygous familiar hypercholesterolemia and advanced CAD enrolled in a chronic apheresis program once a week. Single H.E.L.P. apheresis reduced plasma concentrations of oxidized LDL and malondialdehyde without having an influence on cellular Cu/Zn superoxide dismutase (Cu/ZnSOD). The antioxidative serum capacity declined to some degree after apheresis whereas plasma concentration of 8-isoprostan- PGF2 alpha increased.In H.E.L.P. apheresis, the antioxidative effects prevail. Oxidation of lipids and severe modification of enzymatic and non-enzymatic antioxidants during extracorporeal circulation do not counterbalance the benefit of LDL reduction.
