"First in Man": Case Report of Selective C-Reactive Protein Apheresis in a Patient with Acute ST Segment Elevation
Wolfgang Ries1, Ahmed Sheriff2, Franz Heigl3
1Diakonissen Hospital Flensburg, Medical Clinic, Flensburg, Germany.
Insights
Selective C-reactive protein (CRP) apheresis was successfully used in a male patient with myocardial infarction. This novel approach reduced CRP levels without side effects, offering insights into CRP
Area of Science:
- Cardiology
- Immunology
- Biomedical Engineering
Background:
- C-reactive protein (CRP) is implicated in cardiovascular disease pathogenesis.
- No specific CRP inhibitors for human use are currently available.
- ST-segment elevation myocardial infarction (STEMI) requires prompt intervention.
Observation:
- A 69-year-old male STEMI patient underwent emergency angioplasty and stenting.
- Selective CRP apheresis was performed using PentraSorb® CRP on two occasions.
- Plasma CRP levels were significantly reduced after each apheresis session.
Findings:
- CRP levels decreased from 28.77 mg/l to 12.58 mg/l after the first session.
- CRP levels decreased from 24.17 mg/l to 11.55 mg/l after the second session.
- No adverse side effects were reported during the procedure.
Implications:
- This is the first report of selective CRP apheresis in a male patient.
- CRP apheresis technology may help elucidate the role of CRP in disease.
- This method offers potential therapeutic strategies for cardiovascular conditions.
Abstract:
C-reactive protein (CRP) may be causative in cardiovascular disease. As yet, no specific CRP inhibitor for human application has been described. A 69-year-old male was referred with ST segment elevation myocardial infarction (STEMI). Typical symptoms of chest pain started at 10.00 p.m. The patient was admitted to the hospital at 1.30 a.m. the next day. As ECG showed anterior wall myocardial infarction, the patient was immediately transferred to successful emergency angioplasty/drug-eluting- (DE-) stenting of the subtotally occluded left anterior descending artery. Consecutively, the hemodynamically stable patient was monitored at the chest pain unit. C-reactive protein (CRP) apheresis using the CRP adsorber (PentraSorb® CRP) within CAMI-1 trial was performed 34 h and 58 h after the onset of symptoms. In each apheresis session, 6000 ml plasma was treated via peripheral venous access. Plasma CRP levels decreased from 28.77 mg/l to 12.58 mg/l during the first apheresis session and from 24.17 mg/l to 11.55 mg/l during the second session, respectively. No side effects were observed. This is the first report of selective CRP apheresis in a man. The technology offers multiple opportunities to clarify the immunological/pathogenic role of CRP in health and disease.
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