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Single LDL‐Cholesterol Apheresis Treatment Does Not Improve Vascular Endothelial Function in Hypercholesterolemic Patients
Author(s) -
Ballard Kevin,
Taylor Beth,
Beam Jo Ellen,
Mah Eunice,
Guo Yi,
Bruno Richard,
Polk Donna,
Thompson Paul
Publication year - 2015
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.29.1_supplement.643.1
Subject(s) - asymmetric dimethylarginine , medicine , malondialdehyde , oxidative stress , ldl apheresis , endothelial dysfunction , brachial artery , endocrinology , apheresis , cholesterol , nitric oxide , chemistry , lipoprotein , platelet , biochemistry , arginine , blood pressure , amino acid
Low‐density lipoprotein cholesterol (LDL‐C) apheresis is an effective therapy to reduce CVD risk in hypercholesterolemic patients who are refractory or intolerant to lipid‐lowering therapy. We hypothesized that a single treatment of LDL‐C apheresis would increase vascular endothelial function by decreasing oxidative stress responses that limit nitric oxide (NO) bioavailability. Patients (n=5; 52±11 y) were actively receiving bi‐weekly LDL‐C apheresis treatments (duration=54±41 mo). Brachial artery flow‐mediated dilation (FMD), plasma lipids, vitamin E (α‐ and γ‐tocopherol), markers of oxidative stress (nitro‐γ‐tocopherol, malondialdehyde (MDA)), and regulators of NO metabolism (arginine (ARG), asymmetric dimethylarginine (ADMA)) were assessed prior to (Pre) and immediately following LDL‐C apheresis (Post) and at 1, 3, 7, and 14 d Post. Relative to Pre, total C (300±58 mg/dL) and LDL‐C (239±46 mg/dL) at Post were 61% and 70% lower (P<0.01), respectively, and remained 46‐56%, 27‐34%, and 14‐16% lower at 1, 3, and 7 d, respectively. Plasma α‐, γ‐, and nitro‐γ‐tocopherol concentrations were 52‐69% lower at Post (P<0.01), and α‐tocopherol remained 36% lower at 1 d while nitro‐γ‐tocopherol remained 41% lower at d 3. Brachial FMD responses (6.9±3.6%) and plasma MDA, ARG, and ADMA concentrations were unaffected following LDL‐C apheresis. A single LDL‐C apheresis session did not alter FMD in patients treated chronically for hypercholesterolemia, a finding potentially attributed to the effect of chronic treatment or the decline in plasma antioxidants induced by cholesterol lowering. Funded by Kaneka Pharma, LLC