Lipoprotein Apheresis in the Treatment of Dyslipidemia - the Czech Republic Experience

Kód výsledku v IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F17%3A10365982" target="_blank" >RIV/00216208:11150/17:10365982 - isvavai.cz</a>

Nalezeny alternativní kódy

RIV/00179906:_____/17:10365982

Výsledek na webu

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DOI - Digital Object Identifier

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Jazyk výsledku

angličtina

Název v původním jazyce

Lipoprotein Apheresis in the Treatment of Dyslipidemia - the Czech Republic Experience

Popis výsledku v původním jazyce

In 1984, we started using therapeutic plasmapheresis (plasma exchange) as a method of extracorporeal lipoprotein elimination for the treatment of hypercholesterolemic patients. We evaluated the results of long-term therapy in 14 patients, 8 men and 6 women. The average age was 55.6 +/- 13.2 (range 28-70), median 59.5 years.14 patients were diagnosed with familial hypercholesterolemia (FH): 5 homozygous, 9 heterozygous. Ten patients in the group were treated using immunoadsorption lipoprotein apheresis and 4 using hemorheopheresis. Immunoapheretic interventions decreased LDL-cholesterol (82 +/- 1 %), ApoB (73 +/- 13 %) and even Lp( a) by 82 +/- 19 %, respectively. Selected non-invasive methods are important for long-term and repeated follow-up. Carotid intima-media thickness showed improvement or stagnation in 75 % of the patients. Biomarkers of endothelial dysfunction such as endoglin ( in the control group:3.85 +/- 1.25 mu g/l, in lipoprotein apheresis-treated hypercholesterolemic individuals 5.74 +/- 1.47 mu g/l), CD40 ligand (before lipoprotein apheresis:6498 +/- 2529 ng/l, after lipoprotein apheresis: 4057 +/- 2560 ng/l) and neopterin (before lipoprotein apheresis: 5.7 +/- 1.1 nmol/l, after lipoprotein apheresis: 5.5 +/- 1.3 nmol/l) related to the course of atherosclerosis, but did not reflect the actual activity of the disease nor facilitate the prediction or planning of therapy. Hemorheopheresis may improve blood flow in microcirculation in familial hypercholesterolemia and also in some other microcirculation disorders via significantly decreased activity of thrombomodulin (p &lt; 0.0001), tissue factor (p &lt; 0.0001), aggregation of thrombocytes (p&lt; 0.0001) and plasma and whole blood viscosity (p &lt; 0.0001). In conclusion, lipoprotein apheresis and hemorheopheresis substantially lowered LDL-cholesterol in severe hypercholesterolemia. Our experience with long-term therapy also shows good tolerance and a small number of complications (6.26 % non-serious clinical complications).

Název v anglickém jazyce

Lipoprotein Apheresis in the Treatment of Dyslipidemia - the Czech Republic Experience

Popis výsledku anglicky

In 1984, we started using therapeutic plasmapheresis (plasma exchange) as a method of extracorporeal lipoprotein elimination for the treatment of hypercholesterolemic patients. We evaluated the results of long-term therapy in 14 patients, 8 men and 6 women. The average age was 55.6 +/- 13.2 (range 28-70), median 59.5 years.14 patients were diagnosed with familial hypercholesterolemia (FH): 5 homozygous, 9 heterozygous. Ten patients in the group were treated using immunoadsorption lipoprotein apheresis and 4 using hemorheopheresis. Immunoapheretic interventions decreased LDL-cholesterol (82 +/- 1 %), ApoB (73 +/- 13 %) and even Lp( a) by 82 +/- 19 %, respectively. Selected non-invasive methods are important for long-term and repeated follow-up. Carotid intima-media thickness showed improvement or stagnation in 75 % of the patients. Biomarkers of endothelial dysfunction such as endoglin ( in the control group:3.85 +/- 1.25 mu g/l, in lipoprotein apheresis-treated hypercholesterolemic individuals 5.74 +/- 1.47 mu g/l), CD40 ligand (before lipoprotein apheresis:6498 +/- 2529 ng/l, after lipoprotein apheresis: 4057 +/- 2560 ng/l) and neopterin (before lipoprotein apheresis: 5.7 +/- 1.1 nmol/l, after lipoprotein apheresis: 5.5 +/- 1.3 nmol/l) related to the course of atherosclerosis, but did not reflect the actual activity of the disease nor facilitate the prediction or planning of therapy. Hemorheopheresis may improve blood flow in microcirculation in familial hypercholesterolemia and also in some other microcirculation disorders via significantly decreased activity of thrombomodulin (p &lt; 0.0001), tissue factor (p &lt; 0.0001), aggregation of thrombocytes (p&lt; 0.0001) and plasma and whole blood viscosity (p &lt; 0.0001). In conclusion, lipoprotein apheresis and hemorheopheresis substantially lowered LDL-cholesterol in severe hypercholesterolemia. Our experience with long-term therapy also shows good tolerance and a small number of complications (6.26 % non-serious clinical complications).

Druh

J_imp - Článek v periodiku v databázi Web of Science

CEP obor

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OECD FORD obor

30202 - Endocrinology and metabolism (including diabetes, hormones)

Projekt

<a href="/cs/project/NV17-28882A" target="_blank" >NV17-28882A: Genetické polymorfismy, MiRNA a vybrané bioindikátory aktivity - vzájemné vztahy při diagnostice a léčbě těžké familiární hypercholesterolemie</a><br>

Návaznosti

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Rok uplatnění

2017

Kód důvěrnosti údajů

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Název periodika

Physiological Research

ISSN

0862-8408

e-ISSN

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Svazek periodika

66

Číslo periodika v rámci svazku

Suppl. 1

Stát vydavatele periodika

CZ - Česká republika

Počet stran výsledku

10

Strana od-do

"S91"-"S100"

Kód UT WoS článku

000398620900011

EID výsledku v databázi Scopus

2-s2.0-85017145448