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Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation

Isolation and Analysis of Plasma Lipoproteins by Ultracentrifugation

Published on: January 28, 2021

Lipoprotein apheresis: present and future uses.

Patrick M Moriarty¹

¹Atherosclerosis and Lipoprotein Apheresis Center, University of Kansas Medical Center, Kansas City, Kansas.

Current Opinion in Lipidology

|January 19, 2016

Summary

Lipoprotein apheresis effectively lowers LDL-C and vascular inflammation but may be less common for familial hypercholesterolemia due to new therapies. Its future lies in treating other vascular diseases.

Area of Science:

Cardiovascular Medicine
Lipidology
Apheresis Therapy

Background:

Lipoprotein apheresis has been a primary therapy for familial hypercholesterolemia (FH) patients with uncontrolled LDL-C and cardiovascular disease for 40 years.
The emergence of novel lipid-modifying agents prompts a re-evaluation of lipoprotein apheresis's role.

Purpose of the Study:

To review the current status and future implications of lipoprotein apheresis in light of advancements in lipid-lowering therapies.
To explore potential new applications for lipoprotein apheresis beyond FH.

Main Methods:

Review of existing literature on lipoprotein apheresis, lipid-modifying agents, and cardiovascular disease.
Analysis of the impact of lipoprotein apheresis on plasma lipids, vascular inflammation, and blood rheology.

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Examination of regulatory approvals and clinical outcomes in various vascular conditions.

Main Results:

Lipoprotein apheresis reduces apolipoprotein B lipoproteins, vascular inflammation, and improves blood rheology.
Therapy has shown benefits in nephrotic syndrome and peripheral arterial disease, with FDA approval for focal segmental glomerulosclerosis.
German approval exists for elevated lipoprotein(a) with cardiovascular disease, regardless of LDL-C levels.

Conclusions:

New lipid-modifying therapies are expected to decrease the use of lipoprotein apheresis for FH.
Future applications may focus on vascular diseases lacking effective treatments, where apheresis can improve outcomes by reducing lipids, inflammation, and improving rheology.