Kostner K, Banyai S, Jansen M, Khoschsorur G, Hörl W H, Maurer G, Winklhofer-Roob B, Derfler K
Department of Cardiology, University of Vienna, Waehringerguertel 18-20, A-1090, Vienna, Austria.
Clin Chim Acta. 1999 Oct;288(1-2):21-30. doi: 10.1016/s0009-8981(99)00087-x.
Extracorporeal elimination of low density lipoprotein (LDL) is frequently used in drug-resistant hypercholesterolemia. LDL-immunoapheresis selectively removes LDL and lipoprotein(a) [Lp(a)] from plasma. Lipid peroxidation is one unwanted side effect, that occurs during extracorporeal plasma treatment. The purpose of this study was to investigate the effect of LDL immunoapheresis on lipid peroxidation. Before and after a single LDL-immunoapheresis treatment, plasma concentrations of lipid hydroperoxides, determined with two different spectophotometric assays, thiobarbituric acid-reacting substances (TBARS), determined spectrophotometrically and malondialdehyde (MDA), determined by an MDA-TBA/HPLC method, were measured in 13 hypercholesterolemic patients. In addition MDA was also determined in the eluate of the apheresis column. Before treatment, plasma cholesterol and LDL cholesterol concentrations were significantly higher in patients than in healthy control subjects, as were the lipid peroxidation products. LDL-immunoapheresis treatment of the patients led to significant decreases in total cholesterol (69+/-8%), LDL-cholesterol (79+/-7%), HDL-cholesterol (35+/-17%), triglycerides (38+/-21%), apolipoprotein-B (77+/-6%), apolipoprotein-A1 (25+/-5%) and Lp(a) concentrations (76+/-10%). Changes in plasma lipid peroxide concentrations (17+/-8 nmol/l before vs. 14+/-5 nmol/l after treatment) were not significant, neither were those in TBARS (3. 0+/-2.6 micromol/l vs. 2.3+/-1.3 micromol/l) or MDA concentrations (1.03+/-0.17 micromol/l vs. 1.0+/-0.20 micromol/l). Patients with high baseline values showed a decrease, whereas others did not. MDA was present (0.57+/-0.13 micromol/l) in the eluate of the apheresis column, suggesting that, along with LDL, lipid peroxidation products are also removed. From these results we conclude that a single LDL-immunoapheresis treatment effectively reduces LDL and Lp(a) in the absence of increases in plasma lipid peroxidation products.
体外清除低密度脂蛋白（LDL）常用于治疗耐药性高胆固醇血症。LDL免疫吸附疗法可从血浆中选择性去除LDL和脂蛋白（a）[Lp（a）]。脂质过氧化是体外血浆治疗过程中出现的一种不良副作用。本研究旨在探讨LDL免疫吸附疗法对脂质过氧化的影响。在13例高胆固醇血症患者接受单次LDL免疫吸附治疗前后，采用两种不同的分光光度法测定血浆脂质过氧化物浓度，用分光光度法测定硫代巴比妥酸反应物质（TBARS），并用MDA-TBA/HPLC法测定丙二醛（MDA）。此外，还测定了免疫吸附柱洗脱液中的MDA。治疗前，患者血浆胆固醇和LDL胆固醇浓度显著高于健康对照者，脂质过氧化产物浓度也是如此。对患者进行LDL免疫吸附治疗后，总胆固醇（69±8%）、LDL胆固醇（79±7%）、HDL胆固醇（35±17%）、甘油三酯（38±21%）、载脂蛋白B（77±6%）、载脂蛋白A1（25±5%）和Lp（a）浓度均显著降低。血浆脂质过氧化物浓度变化（治疗前17±8 nmol/l，治疗后14±5 nmol/l）不显著，TBARS（3.0±2.6 μmol/l vs. 2.3±1.3 μmol/l）或MDA浓度（1.03±0.17 μmol/l vs. 1.0±0.20 μmol/l）变化也不显著。基线值高的患者有所下降，而其他患者则没有。免疫吸附柱洗脱液中存在MDA（0.57±0.13 μmol/l），这表明脂质过氧化产物与LDL一起被清除。从这些结果我们得出结论，单次LDL免疫吸附治疗可有效降低LDL和Lp（a），而不会增加血浆脂质过氧化产物。
