Baricchi R, Pizzala R, Cacciavillani G, Rivasi P, Tomasi A
Servizio d'Immunoematologia e Trasfusionale, Arcispedale S. Maria Nuova Azienda Ospedaliera, Reggio Emilia, Pavia, Italy.
Ther Apher. 1998 Aug;2(3):218-23. doi: 10.1111/j.1744-9987.1998.tb00107.x.
Familial hypercholesterolemia (FH) is an autosomal dominant genetic disorder characterized by a lifelong elevation in the concentration of low-density lipoprotein (LDL) bound cholesterol in blood by cholesterol deposits and by early coronary artery disease. The LDL apheresis technique has been introduced with the goal of reducing LDL cholesterol levels, thereby preventing the development of atherosclerosis. The literature on LDL apheresis reports 2 different facets, the therapeutic aspect associated with the lessening of LDL concentration and the initiation of a peroxidation process associated with the biocompatibility of the artificial membrane. Lipid and protein peroxidation gives rise to toxic and atherogenic hydroperoxide, mostly lipid hydroperoxides, and derivative compounds, which may offset the benefit of the procedure. In this paper, plasma hydroperoxide levels are determined along with the elevation of the serum and LDL antioxidant status in hypercholesterolemic patients before and following repeated LDL apheresis sessions. Hydroperoxide concentration has been expressed both in terms of plasma volume and LDL concentration. A highly significant increase in LDL lipid hydroperoxides is demonstrated when expressed in terms of LDL concentration and is associated with the LDL apheresis procedure. The usefulness of antioxidant supplementation in LDL apheresis is discussed.
家族性高胆固醇血症（FH）是一种常染色体显性遗传疾病，其特征为血液中与低密度脂蛋白（LDL）结合的胆固醇浓度因胆固醇沉积而终生升高，并伴有早发性冠状动脉疾病。低密度脂蛋白分离术已被引入，目的是降低低密度脂蛋白胆固醇水平，从而预防动脉粥样硬化的发展。关于低密度脂蛋白分离术的文献报道了两个不同方面，一个是与低密度脂蛋白浓度降低相关的治疗方面，另一个是与人工膜生物相容性相关的过氧化过程的启动。脂质和蛋白质过氧化会产生有毒且致动脉粥样硬化的氢过氧化物，主要是脂质氢过氧化物及其衍生化合物，这可能会抵消该治疗方法的益处。在本文中，对高胆固醇血症患者在重复进行低密度脂蛋白分离术前后的血浆氢过氧化物水平以及血清和低密度脂蛋白抗氧化状态的升高情况进行了测定。氢过氧化物浓度已分别根据血浆体积和低密度脂蛋白浓度进行了表示。当以低密度脂蛋白浓度表示时，低密度脂蛋白脂质氢过氧化物有高度显著的增加，且与低密度脂蛋白分离术有关。文中还讨论了在低密度脂蛋白分离术中补充抗氧化剂的作用。
