Abstract 663: Acute Changes in Oxidative and Inflammatory Markers with LDL Apheresis
LDL-apheresis is efficacious in reducing CHOL and LDL in patients with hypercholesterolemia that cannot be fully treated by diet and drug therapy. A 50 – 60% reduction in CHOL and LDL is usually observed after treatment. Increased plasma concentrations of oxidatively modified products (oxLDL and nitrotyrosinated proteins) and inflammatory markers (hsCRP) characterize these patients before therapy. The change in these latter measures was assessed in 10 subjects (8 women + 2 men) before and after three treatments each over a 6-week period. Lipids (mg/dL) were measured by enzymatic methods, apolipoproteins (mg/dL) and hsCRP (mg/L) by immunoturbidometric methods. oxLDL (AU/L), nitrotyrosine-modified proteins (nM), and autoantibodies against malondialdehyde-modified LDL (AU/L) were determined by ELISA. Before treatment, values for all parameters were not different over time. The mean changes in all parameters were consistent with all three treatments. Mean reduction (pre and post levels) in lipids and lipoproteins was: CHOL −53% (281 to 134, p<0.001); LDL −61% (195 to 78, p<0.001). Reductions in: TG −49% (233 to 123), apoB −49% (205 to 104), Lp(a) −66% (14.2 to 4.3), apoC-III −40% (16.4 to 9.7) and apoE −47% (5.7 to 3.0) were statistically significant, p<0.005. HDL-C fell −28% (51 to 37.1) and apoA-I −18% (150 to 123), p<0.001. The changes in TG and HDL may be due in part by the heparin used in the procedure. oxLDL was reduced by 61% (13 to 5.1, p<0.001) the same as the reduction in LDL. Nitrotyrosinated proteins were reduced by 37% (20.9 to 11.7, p<0.002). Autoantibodies against mda-LDL were low in these subjects as compared to controls and were also reduced by 37% (510 to 370, p<0.001). hsCRP was significantly reduced by LDL-apheresis from 3.1 to 1.4 (54%, p<0.005). In addition to significant reductions in CHOL, LDL, apoB and Lp(a), LDL-apheresis may also reduce the progression of atherosclerosis by reducing oxidative and inflammatory markers such as oxLDL and hsCRP.