Beyond lowering circulating LDL: Apheresis-induced changes of systemic oxidative stress markers by four different techniques

Abstract

Objective and methods Dyslipidemia and oxidative stress are causally related to atherogenesis and cardiovascular disease. We assessed acute changes of systemic oxidative stress biomarkers in thirty-two patients undergoing regular apheresis using four different techniques: heparin-induced extracorporeal LDL precipitation (HELP), direct adsorption of lipoproteins (DALI), lipidfiltration (LF), and immunoadsorption of lipoproteins (IA). Results All apheresis procedures were similarly effective in lowering LDL cholesterol (−2.5±0.2 mmoL/L), oxidized LDL (−52.4±4.4 U/L), and levels of antioxLDL antibodies (−59.5±15.1 U/L). Among the LDL-apheresis methods investigated, only the DALI technique without prior separation of blood plasma led to a decline in leukocyte count (p=0.01 vs. LF post apheresis) and to decreased phagocyte oxidant-generating activity as evaluated by chemiluminescence. Moreover, DALI was followed by a smaller decrease of blood total antioxidant capacity than the other techniques (p<0.01 vs. HELP post apheresis). Conclusion Together, our data suggest that compared with other common techniques, the DALI apheresis system is accompanied by the lowest systemic oxidative burden evoked by a single apheresis treatment.