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Activation of Lipid Mediator Formation Due to Lipoprotein Apheresis

Karsten-H Weylandt1,2, Christoph Schmöcker3, Annika I Ostermann4

  • 1Medical Department, Divisions of Hepatology, Gastroenterology, Oncology, Hematologyand Diabetes, Ruppiner Kliniken, Brandenburg Medical School, 16816 Neuruppin, Germany. karsten.weylandt@charite.de.

Nutrients
|February 13, 2019
PubMed

Insights

Lipid apheresis lowers cholesterol but reduces essential fatty acids. Certain methods, like HELP apheresis, increase pro-inflammatory lipid mediators, suggesting omega-3 fatty acid supplementation may offer cardioprotective benefits.

Area of Science:

  • Cardiovascular Medicine
  • Biochemistry
  • Lipid Metabolism

Background:

  • Lipoprotein apheresis effectively lowers LDL cholesterol in patients with atherosclerotic disease and hypercholesterolemia.
  • Apheresis treatments can decrease levels of essential omega-6 and omega-3 polyunsaturated fatty acids (PUFAs).
  • Heparin-induced extracorporeal LDL precipitation (HELP) apheresis may promote pro-inflammatory lipid mediators derived from PUFAs.

Purpose of the Study:

  • To analyze lipid mediator profiles in hyperlipidemia patients undergoing different apheresis methods.
  • To compare pre- and post-apheresis changes in fatty acid composition and oxylipin formation.
  • To investigate the impact of HELP, direct absorption (DA), and membrane filtration (MDF) apheresis on lipid mediators.

Main Methods:

  • Analysis of plasma lipid mediator profiles using gas chromatography and liquid chromatography tandem mass spectrometry (LC-MS/MS).
  • Direct pre- and post-apheresis comparison of patients treated with HELP, DA, or MDF apheresis.
  • Quantification of fatty acid composition and oxylipin levels.

Main Results:

  • Significant decreases in omega-6 and omega-3 PUFAs were observed, particularly in HELP-treated patients.
  • Significant increases in PUFA-derived lipoxygenase-, cyclooxygenase-, and cytochrome P450-derived lipid mediators were noted.
  • HELP apheresis showed a distinct impact on lipid mediator profiles compared to DA and MDF.

Conclusions:

  • Lipid apheresis, especially HELP, alters essential PUFA levels and increases potentially pro-inflammatory lipid mediators.
  • Omega-3 PUFAs are considered cardioprotective, and their derived mediators may reduce inflammation.
  • Omega-3 PUFA supplementation during apheresis could enhance cardioprotective effects via apheresis-triggered mediators.

Keywords:
LC-MS/MSdocosahexaenoic acidgas chromatographyhyperlipoproteinaemialipid apheresislipid mediatorslipidomicsn-3 PUFAn-6 PUFA.omega-3 polyunsaturated fatty acids, eicosapentaenoic acidoxylipins

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