Effects of heparin-mediated extracorporeal low-density lipoprotein precipitation beyond lowering proatherogenic lipoproteins—reduction of circulating proinflammatory and procoagulatory markers

• Published in: Atherosclerosis Vol. 175; no. 1; pp. 145 - 150
• Main Authors: Wang, Ying, Blessing, Frithjof, Walli, Autar K., Überfuhr, Peter, Fraunberger, Peter, Seidel, Dietrich
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier Ireland Ltd 01-07-2004; Elsevier
• Subjects: Adhesion molecules; Arteriosclerosis - blood; Arteriosclerosis - prevention & control; Atherosclerosis; Atherosclerosis (general aspects, experimental research); Biological and medical sciences; Blood and lymphatic vessels; Blood Coagulation Factors - analysis; Blood Component Removal; Blood. Blood coagulation. Reticuloendothelial system; C-Reactive Protein - analysis; Cardiology. Vascular system; Cardiovascular system; CD40 Antigens - blood; Cell Adhesion Molecules - blood; Endothelin-1; Female; HELP; Homocysteine - blood; Humans; Hyperlipoproteinemia Type II - blood; Hyperlipoproteinemia Type II - complications; Hyperlipoproteinemia Type II - therapy; Inflammation Mediators - blood; Lipopolysaccharide binding protein; Lipoproteins, LDL - blood; Male; Medical sciences; Middle Aged; Monocyte chemoattractant protein-1; Pharmacology. Drug treatments; Soluble CD40 ligand; Tissue factor; Vasodilator agents. Cerebral vasodilators; HELP; Monocyte chemoattractant protein-1; MCP-1; Tissue factor; sE-selectin; Soluble CD40 ligand; sVCAM-1; TF; ET-1; Lipopolysaccharide binding protein; Atherosclerosis; Endothelin-1; Hs-CRP; Adhesion molecules; LBP; Monocyte; Cardiovascular disease; Anticoagulant; Endothelin 1; Lipoprotein; Vascular disease; Binding protein; Lipopolysaccharide; Glycosaminoglycan; Heparin
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2004.03.011

In addition to hypercholesterolemia, proinflammatory and prothrombotic markers have been suggested to play an important role in atherogenesis. We examined whether heparin-mediated extracorporeal low-density lipoprotein precipitation (HELP) therapy modulates the circulating levels of proinflammatory and prothrombotic markers. Twenty-two coronary heart disease (CHD) patients undergoing regular HELP-apheresis (18 males, 4 females, mean age 57.3±10.9 years) were enrolled in this study. A single HELP therapy treatment significantly decreased the circulating levels of high sensitivity C-reactive protein (hs-CRP), soluble vascular adhesion molecule-1 (sVCAM-1), soluble E-selectin, lipopolysaccharide binding protein (LBP), endothelin-1 (ET-1), and monocyte chemoattractant protein-1 (MCP-1) on average by 67, 37, 24, 27, 24, and 15%, respectively. Prothrombotic factors including fibrinogen, tissue factor (TF), soluble CD40 ligand (sCD40L), and homocysteine were decreased by 66, 27, 16, and 22%, respectively. In accordance with previous studies HELP therapy reduced total cholesterol, low density lipoprotein (LDL) cholesterol, and Lp(a) mass by 50, 61, and 62%, respectively. Our data suggest that simultaneous reduction of proinflammatory and prothrombotic factors together with atherogenic lipoproteins by HELP-apheresis may contribute to improvement of endothelial dysfunction and thereby inhibit progression of atherosclerotic lesions and stabilize the existing plaque.