[Efficacy of 2 cholesterol apheresis systems]

Area of Science:

• Cardiovascular Medicine
• Biomedical Engineering
• Lipid Metabolism

Background:

• Hypercholesterolemia poses significant cardiovascular risks.
• Selective removal of low-density lipoprotein (LDL) cholesterol is a therapeutic goal.
• Plasma treatment techniques offer potential for targeted molecule extraction.

Purpose of the Study:

• To investigate and compare the efficacy of double filtration plasmapheresis and dextran sulfate cellulose column plasmapheresis for selective LDL cholesterol removal.
• To assess the impact of these treatments on apolipoproteins (Apo A1, Apo B) and coagulation factors.
• To evaluate the selectivity and potential side effects of the dextran sulfate procedure.

Main Methods:

• Investigated selective LDL cholesterol removal from 3-4 liters of plasma in 4 hypercholesterolemic patients.
• Employed double filtration (cascade filtration) and dextran sulfate cellulose column plasmapheresis.
• Measured extraction rates for Apo A1, Apo B, and concentrations of coagulation factors (V, VIII, fibrinogen).

Main Results:

• Both methods effectively reduced LDL cholesterol.
• Dextran sulfate showed higher Apo B extraction (50-90%) than cascade filtration (similar to dextran sulfate).
• Cascade filtration had higher Apo A1 extraction (25-50%) compared to dextran sulfate (<25%).
• Both techniques decreased coagulation factors V, VIII, and fibrinogen.
• Dextran sulfate was more selective but expensive, with observed side effects possibly due to dextran sulfate release.

Conclusions:

• Both cascade filtration and dextran sulfate plasmapheresis are effective for LDL cholesterol removal.
• Dextran sulfate offers greater selectivity but presents higher costs and potential adverse effects.
• Further research is needed to mitigate side effects associated with dextran sulfate plasmapheresis.