The Impact of Lipoprotein Apheresis on Oxidative Stress Biomarkers and High-Density Lipoprotein Subfractions.

Agnieszka Mickiewicz,Agnieszka Ćwiklińska,Agnieszka Kuchta,Maciej Jankowski,Ewelina Kreft,Marcin Fijałkowski,Marcin Gruchała,Milena Paprzycka,Ewa Wieczorek,Joanna Marlęga

doi:10.1155/2020/9709542

Agnieszka Mickiewicz, Agnieszka Ćwiklińska + Show 8 more

Open Access

https://doi.org/10.1155/2020/9709542

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Abstract

Lipoprotein apheresis (LA) treatment results in a substantial reduction of low-density lipoprotein- (LDL-) cholesterol and lipoprotein(a) concentrations, which consequently decreases the rate of cardiovascular events. The additional benefit of LA may be associated with its impact on the composition and quality of high-density lipoprotein (HDL) particles, inflammation, and oxidative stress condition. To verify the effects of LA procedure, the current study is aimed at analyzing the effect of a single apheresis procedure with direct hemadsorption (DALI) and cascade filtration (MONET) on oxidative stress markers and HDL-related parameters. The study included eleven patients with familial hypercholesterolemia and hyperlipoproteinemia(a) treated with regular LA (DALI or MONET). We investigated the pre- and postapheresis concentration of the lipid-related oxidative stress markers 8-isoPGF2, oxLDL, TBARS, and PON-1. We also tracked potential changes in the main HDL apolipoproteins (ApoA-I, ApoA-II) and cholesterol contained in HDL subfractions. A single session of LA with DALI or MONET techniques resulted in a similar reduction of lipid-related oxidative stress markers. Concentrations of 8-isoPGF2 and TBARS were reduced by ~60% and ~30%, respectively. LA resulted in a 67% decrease in oxLDL levels along with a ~19% reduction in the oxLDL/ApoB ratio. Concentrations of HDL cholesterol, ApoA-I, ApoA-II, and PON-1 activity were also reduced by LA sessions, with more noticeable effects seen in the MONET technique. The quantitative proportions between HDL2 and HDL3 cholesterol did not change significantly by both methods. In conclusion, LA treatment with MONET or DALI system has a small nonselective effect on lowering HDL particles without any changes in the protein composition of these particles. Significant reduction in the level of oxidative stress parameters and less oxidation of LDL particles may provide an additional benefit of LA therapy.

Highlights

Atherosclerosis and related cardiovascular disease represent a major health problem in Western countries and constitute a leading cause of morbidity and mortality [1]
We have shown that the MONET and DALI techniques are similar in terms of the reduction of stress marker levels and proatherogenic lipoproteins
The obtained results are in line with previously published data [16] and confirmed the selectivity of atherogenic lipid removal, showing only a slight reduction in high-density lipoproteins (HDL) cholesterol levels, which was more noticeable with the MONET technique

Summary

Introduction

Atherosclerosis and related cardiovascular disease represent a major health problem in Western countries and constitute a leading cause of morbidity and mortality [1]. The relationship among elevated low-density lipoprotein (LDL) particles, their oxidation, and the progression of atherosclerosis is well recognized [2]. An increased lipoprotein(a) (lp(a)) level was identified as a major cardiovascular lipidrelated risk factor [3, 4]. Individuals with severe familial hypercholesterolemia (FH) and those with high levels of lp(a) may require extracorporeal treatment with lipoprotein apheresis (LA). Specific columns remove LDL particles and lp(a) and affect the concentration of chylomicrons, very-lowdensity lipoproteins (VLDL), and high-density lipoproteins (HDL) [6].

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