Improvement of oxidative stress status by lipoprotein apheresis in Chinese patients with familial hypercholesterolemia.

Jun Wen,Xiao‐Lin Li,Ying Gao,Jian‐Jun Li,Qian Dong,Yuan‐Lin Guo,Geng Liu,Jing‐Lu Jin

doi:10.1002/jcla.23161

Abstract

Background and aimsFamilial hypercholesterolemia (FH) characterized by severe high blood cholesterol levels usually presents an imbalance of systemic oxidative stress (OS). Lipoprotein apheresis (LA), which is the most effective therapy to reduce cholesterol levels, remains unclear in altering OS and scarce in Chinese patient studies. Our study aims to assess the impact of LA on OS status in Chinese patients with FH.MethodsAbout 31 patients (22 males, age: 12‐69 years) with FH and receiving LA treatment were consecutive enrolled. Free oxygen radicals test (FORT) and free oxygen radicals defense (FORD) values were determined using the free oxygen radical monitor and kit immediately before and after LA, while blood samples were collected to measure plasma lipid levels and hs‐CRP by conventional methods. Data were analyzed by paired t test or rank sum test and Spearman‐rho correlation analysis.ResultsBesides plasma lipid levels, the OS status showed that FORTs were significantly decreased and FORD values significantly enhanced immediately after LA treatment compared with before (both P < .01). In addition, the correlation analysis showed that the removal rates (△%) of TC were positively related to the increased rates (△%) of FORD value (ρ = 0.513, P = .003); LDL‐C to FORD (ρ = 0.39, P = .03); Lp(a) to FORD (ρ = 0.473, P = .007); and non‐HDL‐C to FORD (ρ = 0.46, P = .009). However, no significant difference in hsCRP was found.ConclusionsThe present study indicated, besides effectively lowering plasma lipid levels, LA could significantly improve OS status in Chinese patients with FH.

Highlights

Familial hypercholesterolemia (FH) characterized by the anomalous metabolism of low-density lipoprotein and severe hypercholesterolemia is usually a common autosomal dominant disease.[1]
There were plenty of researches showing that elevated oxidative stress (OS) in patients with FH enhanced the proatherogenic effect of LDL cholesterol (LDL-C) and participated in the acceleration of atherosclerosis.[2,3]
Our study reported the effect of a single Lipoprotein apheresis (LA) treatment with improving OS status and decreasing blood lipids in FH patients

Summary

| INTRODUCTION

Familial hypercholesterolemia (FH) characterized by the anomalous metabolism of low-density lipoprotein and severe hypercholesterolemia is usually a common autosomal dominant disease.[1]. LA cannot just reduce high LDL-C concentration and/or Lp(a) levels, and effectively alleviate clinical symptoms and signs of FH patients.[8] In addition, LA treatment is recognized as safe and can improve the prognosis of patients with progressive CVD.[9,10,11] Besides effectively lowering plasma lipid levels, investigations of a single LA treatment on OS parameters, and on the relationship between blood lipids and these parameters were rare and remained conflicts.[12,13,14,15,16,17]. Our study using a systematic FORT and FORD values aims to assess the impact of lipoprotein apheresis on oxidative stress status of Chinese patients with FH, and to study the relationship between the removal rates of blood lipids and the change rates of oxidative stress

| Ethics statement

Findings

| DISCUSSION

| CONCLUSION