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LDL-apheresis reduces P-Selectin, CRP and fibrinogen -- possible important implications for improving atherosclerosis

Shuzo Kobayashi1, Machiko Oka, Hidekazkeu Moriya

  • 1Shonan Kamakura General Hospital, Department of Nephrology and Kidney & Dialysis Center, Yamazaki Kamakura, Japan. shuzo@shonankamakura.or.jp

Therapeutic Apheresis and Dialysis : Official Peer-Reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy
|July 5, 2006
PubMed

Insights

LDL-apheresis significantly reduces inflammatory markers like P-selectin, hsCRP, and fibrinogen in peripheral arterial occlusive disease (PAOD) patients. This suggests anti-inflammatory mechanisms contribute to improved outcomes in PAOD, especially for those on hemodialysis.

Area of Science:

  • Cardiovascular Medicine
  • Inflammation Research
  • Medical Technology

Background:

  • Low-density lipoprotein (LDL) apheresis is known to improve coronary artery stenosis (CAS) and peripheral arterial occlusive disease (PAOD).
  • The precise mechanisms behind these improvements, particularly potential anti-inflammatory effects, are not fully understood.
  • Investigating changes in specific inflammatory markers can elucidate the therapeutic actions of LDL apheresis.

Purpose of the Study:

  • To investigate the potential anti-inflammatory effects of LDL apheresis in patients with PAOD.
  • To assess the impact of LDL apheresis on serum levels of key inflammatory markers: P-selectin, high-sensitivity C-reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1), and fibrinogen.
  • To explore the relevance of these changes for patients with atherosclerotic cardiovascular disorders, including those undergoing hemodialysis (HD).

Main Methods:

  • A study involving 16 patients diagnosed with PAOD, 12 of whom were on hemodialysis (HD).
  • Patients underwent 10 sessions of LDL apheresis over a 5-week period, treating 3000 mL of plasma per session.
  • Serum and plasma levels of P-selectin, hsCRP, MCP-1, and fibrinogen were measured before and after the LDL apheresis treatment course.

Main Results:

  • Significant reductions were observed in serum P-selectin levels (from 516 +/- 153 to 290 +/- 52 ng/mL, P < 0.05).
  • Serum hsCRP levels decreased significantly (from 9.118 +/- 2.649 to 5.587 +/- 2.445 mg/L, P < 0.01).
  • Plasma fibrinogen levels showed a statistically significant decrease (from 196 +/- 9.82 to 149 +/- 7.97 mg/dL, P < 0.01), while MCP-1 levels did not change significantly.

Conclusions:

  • LDL apheresis demonstrates favorable anti-inflammatory effects in PAOD patients by reducing key inflammatory markers.
  • These anti-inflammatory actions likely contribute to the observed improvements in CAS and PAOD.
  • LDL apheresis may be a valuable therapeutic option for patients with atherosclerotic cardiovascular diseases, particularly those on hemodialysis.

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