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Long-term therapeutic efficacy of lipoprotein apheresis on circulating oxidative stress parameters--A comparison of
Steffi Kopprasch1, Stefan R Bornstein1, Sybille Bergmann2
1Department of Internal Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany.
Insights
Dextran sulfate adsorption (DSA) apheresis, unlike lipid filtration (LF), progressively reduces oxidative stress markers in patients undergoing chronic treatment. This suggests DSA offers a beneficial molecular mechanism by lowering the systemic oxidative burden.
Area of Science:
- Cardiovascular Medicine
- Biochemistry
- Medical Technology
Background:
- Chronic lipoprotein apheresis therapy reduces cardiovascular events in high-risk patients.
- Apheresis removes atherogenic lipoproteins like LDL and lipoprotein(a).
- An antioxidative effect of lipoprotein apheresis has been hypothesized.
Purpose of the Study:
- To investigate long-term biochemical effects of two lipoprotein apheresis methods: lipid filtration (LF) and dextran sulfate adsorption (DSA).
- To examine systemic oxidative stress markers at multiple time points during apheresis treatment.
Main Methods:
- Compared 16 patients undergoing LF (n=7) or DSA (n=9) apheresis.
- Assessed systemic oxidative stress markers including blood phagocyte chemiluminescence, oxidized LDL, and antioxLDL antibodies.
- Evaluated markers at the 1st, 40th, and 80th apheresis sessions.
Main Results:
- DSA patients showed significantly higher LDL cholesterol removal and lower HDL cholesterol loss compared to LF patients by the 80th session.
- DSA patients exhibited a long-term, progressive decrease in circulating oxidant generating activity (p < 0.05).
- A single LF session was linked to increased systemic reactive oxygen species generation over time.
Conclusions:
- Long-term DSA apheresis is associated with a gradual reduction in circulating oxidative burden.
- DSA apheresis may offer a beneficial molecular mechanism due to its impact on oxidative stress.
- DSA demonstrates potential advantages over LF in managing oxidative burden during chronic apheresis therapy.
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.
Objectives And Methods:
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.
Conclusion:
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.
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