engleski

Decrease in Oxidatively Modified LDL during Long- term LDL-Apheresis Treatment

The aim of the present study was to follow-up generation of autoantibodies against oxidatively modified LDL in a patient suffering from severe combined hyperlipidemia during long-term LDL apheresis alone or in combination with statin therapy. An ELISA using MDA-LDL as coating antigen measured anti-oxLDL titre. Baseline value of 82.8 2.1 U/ml was reduced only for 7.8% after 2-month of statin therapy, and decrease of 10.7% was achieved by LDL-apheresis treatment. Long-term LDL-apheresis combined with statin was more effective. Multiple comparison among the four 6-month periods showed significant reduction of mean values in II and III semester (58.0 13.8 vs 37.6 6.0 U/ml, p<0.00053) of the treatment. In parallel to the changes in this biochemical parameter, regression of numerous xanthomas was clinically observed. In spite of this, the presence of ox-LDL antibodies was enhanced in comparison to antibody titer detected in a group of age-matched normolipemic controls (n=15 ; 19.4 8.6 ; p<0.01). The significant reduction of baseline total cholesterol (58%), total triglycerides (80%), LDL cholesterol (48%), apoprotein B (50%) and apolipoprotein (a) (61%) may be considered as a good response to the treatment. LDL/HDL cholesterol ratio, an index of atherosclerosis, was significantly reduced from 13.0 to 2.6. Classical lipoprotein parameters showed low correlation coefficients with anti-oxLDL titer. The reason may lie in the possibility that the primary location of the analyzed parameter is not in the circulation. The production of autoantibodies against oxLDL was reduced during LDL-apheresis, indicating a lower level of the atherogenic antigen. The study showed an additional benefit of LDL-apheresis treatment.

Hyperlipemia; LDL-apheresis; Oxidized-LDL

http://dx.doi.org/10.1016/S0168-8227(00)81064-5 ; DOI: 10.1016/S0168-8227(00)81064-5