Lipoprotein apheresis downregulates IL-1α, IL-6 and TNF-α mRNA expression in severe dyslipidaemia

Area of Science:

• Cardiovascular Medicine
• Molecular Biology
• Immunology

Background:

• Dyslipidaemias are linked to cardiovascular mortality via inflammatory atherosclerotic plaques.
• Pro-inflammatory cytokine messenger RNA (mRNA) levels correlate with atherosclerotic disease progression.
• Therapeutic lipoprotein apheresis (LA) is known to reduce plasma lipids and inflammation.

Purpose of the Study:

• To evaluate the effects of LA on the expression of mRNA for key pro-inflammatory cytokines.
• To assess these effects in patients with dyslipidaemia, familial hypercholesterolaemia (HoFH, HeFH), or hyperlipoprotein(a)aemia (hyperLp(a)) and coronary artery disease (CAD).

Main Methods:

• Ten patients (mean age 47 ± 9.2 years) with hyperLp(a) or genetic dyslipidaemia (HoFH, HeFH) and CAD were enrolled.
• Messenger RNA (mRNA) expression levels were determined using reverse transcriptase quantitative polymerase chain reaction (RT-qPCR).

Main Results:

• Lipoprotein apheresis (LA) led to the downregulation of mRNA expression for IL-1α, IL-6, and TNF-α.
• Reductions were observed after the first LA session and progressively increased by the second session.
• Maximum decreases were -49% for IL-1α (p < 0.001), -35% for IL-6 (p < 0.001), and -56% for TNF-α (p < 0.001).

Conclusions:

• Lipoprotein apheresis (LA) suppresses the expression of IL-1α, IL-6, and TNF-α mRNA in patients with dyslipidaemias.
• This suppression may contribute to the arterial anti-inflammatory effects observed with LA therapy.