Single LDL apheresis improves serum remnant-like particle-cholesterol, C-reactive protein, and malondialdehyde-modified-low-density lipoprotein concentrations in Japanese hypercholesterolemic subjects.

Background: Single low-density lipoprotein (LDL)-apheresis may affect serum remnant-like particle-cholesterol (RLP-C), C-reactive protein (CRP) and malondialdehyde-modified (MDA)-LDL concentrations.

Subjects And Methods: Six subjects with hypercholesterolemia (five men, one woman) were involved in this study. Mean age and body mass index of the study subjects were 58+/-3.1 years and 23.6+/-2.07 kg/m(2), respectively. Five of the subjects were diagnosed as heterozygous familial hypercholesterolemia (FH) because of having both marked hypercholesterolemia and Achilles tendon xanthomas. LDL apheresis was introduced and continued using a dextran sulfate cellulose adsorption column technique every 2 weeks. Serum RLP-C was measured using an immunoaffinity mixed gel containing anti-apolipoprotein A-I and anti-apolipoprotein B monoclonal antibody. Serum CRP was measured by latex-enhanced assay. Serum MDA-LDL was measured using monoclonal antibody against MDA-LDL (ML25).

Results: Combined treatment in the steady state pre-treatment yielded a total, LDL- and HDL-cholesterol, and TG concentrations of 5.39+/-0.81, 3.82+/-1.03, 1.24+/-0.29 and 0.92+/-0.43 mmol/l, respectively, and a post-treatment total, LDL- and HDL-cholesterol and TG concentrations of 2.79+/-0.37 (-48%, p<0.001), 1.63+/-0.29 (-57%, p<0.001), 1.18+/-0.26 (-5%, NS) and 0.23+/-0.11 mmol/l (-75%, p<0.001), respectively. Serum RLP-C and CRP concentrations showed a substantial reduction [-73%, p<0.05 for RLP-C; -56%, p<0.05 for CRP] during this procedure. In addition, LDL apheresis was found to also cause a marked reduction in serum MDA-LDL concentration (-61%, p<0.05).

Conclusion: LDL-apheresis is an effective treatment for removing atherogenic factors RLP-C, CRP and MDA-LDL from sera.