Tselmin Sergey, Schmitz Gerd, Julius Ulrich, Bornstein Stefan R, Barthel Andreas, Graessler Juergen
Department of Internal Medicine III, University Hosptial Carl Gustav Carus at the Technische Universität Dresden, Fetscherstr. 74, 01307 Dresden, Germany.
Atheroscler Suppl. 2009 Dec 29;10(5):27-33. doi: 10.1016/S1567-5688(09)71806-9.
Lipid apheresis is an efficient method for reducing cholesterol and triglyceride serum levels, but its effect on other lipid species has not been investigated. This study explored the effect of LDL apheresis on the serum lipidome in hyperlipidemic patients with cardiovascular complications. Lipid analysis was performed before and immediately after a single apheresis procedure in serum samples of six patients treated with different apheresis methods. Conventional lipid parameters (TC, LDL-C, HDL-C, TG) were determined by standard enzymatic methods. Phosphatidylcholines (PC), sphingomyelins (SM), phosphatidylethanolamines (PE), PE-based plasmalogens (PE_pl), lysophosphatidylcholines (LPC), ceramides (Cer), free cholesterol (FC) and cholesterol ester (CE) were detected with electrospray ionization tandem mass spectrometry. LDL apheresis induced a mean reduction of LDL-C by 68% and of HDL-C by 14%, respectively. CE, FC, SM, and Cer revealed an apheresis-induced decrease of about 47%, which was not statistically different from LDL-C reduction. In contrast, the decline of PC (31%), LPC (26%), PE (2%), and PE_pl (37%) after apheresis was significantly lower in comparison to LDL-C reduction, but not statistically different from HDL-C decrease. While the group of PC-species declined uniformly during apheresis, changes in particular LPC-, Cer-, and SM-species revealed significant differences, reflecting their differential distribution in lipoprotein particles and blood cells. We conclude that the acute effect of lipid apheresis on serum lipidome could be predominantly attributed to lipoprotein changes, while blood cell damages during this procedure caused additional, less pronounced changes. The importance of specific changes in particular lipid species remains to be established.
脂质分离术是降低血清胆固醇和甘油三酯水平的有效方法，但尚未对其对其他脂质种类的影响进行研究。本研究探讨了低密度脂蛋白分离术对患有心血管并发症的高脂血症患者血清脂质组的影响。对6例采用不同分离术方法治疗的患者血清样本在单次分离术操作前及操作后立即进行脂质分析。常规脂质参数（总胆固醇、低密度脂蛋白胆固醇、高密度脂蛋白胆固醇、甘油三酯）通过标准酶法测定。采用电喷雾电离串联质谱法检测磷脂酰胆碱（PC）、鞘磷脂（SM）、磷脂酰乙醇胺（PE）、基于PE的缩醛磷脂（PE_pl）、溶血磷脂酰胆碱（LPC）、神经酰胺（Cer）、游离胆固醇（FC）和胆固醇酯（CE）。低密度脂蛋白分离术分别使低密度脂蛋白胆固醇平均降低68%，高密度脂蛋白胆固醇平均降低14%。CE、FC、SM和Cer显示出分离术诱导的约47%的降低，这与低密度脂蛋白胆固醇的降低无统计学差异。相比之下，分离术后PC（31%）、LPC（26%）、PE（2%）和PE_pl（37%）的下降明显低于低密度脂蛋白胆固醇的降低，但与高密度脂蛋白胆固醇的降低无统计学差异。虽然PC种类在分离术期间均匀下降，但特定LPC、Cer和SM种类的变化显示出显著差异，反映了它们在脂蛋白颗粒和血细胞中的差异分布。我们得出结论，脂质分离术对血清脂质组的急性影响可能主要归因于脂蛋白变化，而在此过程中血细胞损伤导致了额外的、不太明显的变化。特定脂质种类中特定变化的重要性仍有待确定。
