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Цель. Изучить связь концентрации липопротеида(а) [Лп(а)], подфракций липопротеидов промежуточной (ЛПП) и низкой (ЛНП) плотности у пациентов с впервые выявленной тяжелой гиперхолестеринемией (ГХС) с вероятностью диагноза семейной ГХС (СГХС). Материал и методы. В исследование включены 114 пациентов с впервые выявленной тяжелой ГХС (холестерин ЛНП >4,9 ммоль/л), без диагноза ишемической болезни сердца и не получавших гиполипидемическую терапию. Для оценки вероятности диагноза СГХС использовали голландские критерии Dutch Lipid Clinics Network. Показатели липидного спектра определяли ферментативным методом; Лп(а)-методом иммуноферментного анализа; подфракции липопротеидов с помощью системы Липопринт ® (Quantimetrix, США). Результаты. Все пациенты были разделены согласно голландским критериям на две группы: I-(n=86) с возможной СГХС (3-5 баллов) и II-(n=28) с определенной или вероятной СГХС (≥6 баллов). Пациенты II группы имели более высокие уровни атерогенных апоВ100-содержащих липопротеидов относительно пациентов I группы:

New chromatographic material based on tryptophil-threonil-tirosine was prepared. This sorbent effectively binds human, sheep, goat and cow immunoglobulins G. New sorbent shows high selectivity for removing immunoglobulins from blood plasma. Effective sorption capacity is 15-25 mg of immunoglobulin G per ml of matrix. Optimal method of covalent attachment ligand to polysaccharide matrix allows achieving high stability of the sorbents in terms of use and storage. This sorbent can be used in medicine and biotechnology.

Aim.To investigate on the relation of lipoproteide(a) (Lpa), subfractions of atherogenic lipoproteides and titers of specific autoantibodies (autoAb) with the presence and severity of carotid arteries (CA) lesion in statin-naïve patients with severe hypercholesterolemia.Materialandmethods.To the study, 133 statin-naïve patients included, age 18 to 75 y.o., with absent clinical signs of coronary heart disease, and with first time diagnosed severe hypercholesterolemia (total cholesterol >7,5 mM/L and/or low density lipoproteides cholesterol >4,9 mM/L) with ultrasound duplex scan data of CA. All patients underwent measurement of Lpa concentration, lipid profile, subfractional content of apoB-100-containing lipoproteides and autoAb titer against them.Results.According to the data from duplex CA scan, patients were selected to 2 groups: control group (n=76) with no CA atherosclerosis; main group — patients with CA stenosis >20% (n=57). The participants of main group were older than controls, with no other clinical or lipid profile differences. Titre of autoAb IgM specific for Lpa and its oxidized modifications was significantly lower in CA atherosclerosis comparing to controls. The grade of CA stenosis in severe hypercholesterolemia patients positively correlated with age (r=0,24, p=0,005) and negatively — with autoAb IgM to apoB100-containing lipoproteides (r=-0,28 and r=-0,26, p<0,005). Also, a correlation found for CA stenosis grade with subfractions of intermediate density lipoproteides of moderate size (r=0,21, p=0,032). AutoAb titre against Lpa was an independent predictor of CA lesion severity regardless the age and traditional risk factors by the data from multifactorial regression. By ROCanalysis with the highest diagnostic value (square under AUC =0,68) the level of autoAb IgM to Lpa lower than 0,083 lab. units, with sensitivity 40% and specificity 88% is related to the lesion of common CA.Conclusion.In patients with severe hypercholesterolemia Lpa is an autoantigen, and IgM autoantibodies to Lpa play antiatherogenic role.

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A novel technique for preparation affinity sorbent based on tyramine and tryptamine was proposed. It was shown that tryptamine-Sepharose and tyramine-Sepharose effectively bind IgG, IgA, lipoprotein (a) (Lp(a)) and low density lipoproteins (LDL) from blood plasma. The sorption capacity is 4-9 mg of IgG, 2-4 mg IgA, 3-5:mg of Lp(a) and 5-7 mg of LDL per mL of gel. It was found that new sorbents can bind Lp(a) and IgG as themselves or in a complex of Lp(a) with IgG. The existence of this complex may indicate the presence of anti-Lp(a) autoantibodies in the blood of some patients. The advantages of new sorbents are easiness of its synthesis and stability during use and storage. In practice they can be applied for medical and biotechnological purposes where it is necessary to bind Lp(a), LDL, IgG, IgA.

Raised level of lipoproteide (a) (Lpa) is an independent risk factor of coronary heart disease (CHD) and is also a monogenic predictor (there is growth of prevalence) of aortic stenosis (AS) with the increase of Lpa in population. Lysophosphatide acid, secreted by an enzyme with phospholipase D activity — autotaxin (ATX) is an inflammatory mediator. Humoral immunity involvement in inflammatory processes in coronary arteries and aortic valve might present with the presence of circulating autoantibodies and shifts in the values of cellular immunity.Aim.To assess the relation of Lpa, ATX and immunity with the presence of AS in chronic CHD patients.Material and methods.To a single moment study, 210 patients were included, with chronic CHD. Patients were selected to two groups by the presence (main group, n=47) or absence (controls, n=163) of degenerative AS by echocardiography. Patients were taking standard CHD therapy. All patients underwent clinical blood count, lipids concentration and Lpa. ATX, C-reactive protein, autoantibodies to ApoB-100 lipoproteides and their Cu2+-oxidated modifications. Phenotypes of apoprotein (a) were assessed in 168 patients.Results.CHD patients with degenerative AS were older (74,2±7,8 versus 67,6±9,4 y., p=0,0007), but did not differ by the clinical and biochemical characteristics, level of Lpa and high sensitive С-reactive protein (hsCRP). Concentration of АТХ in plasma was significantly higher (554±95 and 497±105 ng/mL, p=0,001), but the level of IgM autoantibodies against the oxidated lipoproteid (а) (oxLpa) — significantly lower (10,8 [7,9;15,1] and 13,4 [11,4;16,7] relative units, p<0,001) in the main group comparing to control. Neutrophilic-lymphocytal index also differed significantly in the AS group and non-AS (2,04 [1,56;3,14] and 1,72 [1,39;2,14]). By the results of logistic analysis, the age, level of ATX, titer of autoantibodies to oxLpa and neutrophilic-limphocytal index were significant independent predictors of the degenerative AS.Conclusion.In the patients with chronic CHD, undergoing statin therapy, the levels of ATX, autoantiboides IgM against the oxLpa and relation of neutrophils to lymphocytes, but not the concentration of Lpa and low molecular phenotype of apo(a), were related to AS presence.

Aim. To study the relationship between the concentration of lipoprotein (a) (Lp (a)) and autotaxin (ATX) in patients with and without degenerative aortic valve stenosis (AoS) in the presence of coronary artery disease (CAD).Material and methods. The study included 461 patients (mean age, 66±11 years, men, 323), 354 of whom had CAD with stenosis ≥50% in at least one coronary artery according to angiography. Degenerative AoS was diagnosed with ultrasound. The control group consisted of 107 patients without CAD and degenerative AoS. Concentrations of Lp (a), ATX, lipids and blood cells were measured for all patients.Results. CAD without degenerative AoS (group 1) was diagnosed in 307 patients, while 47 patients had CAD and degenerative AoS (group 2). Patients in both groups were older than patients in the control group (66±10, 74±8, and 61±13 years, respectively). The ATX level was lower in group 1 (median [25; 75%]: 495 [406; 583] ng/ml) than in the control group (545 [412; 654] ng/ml) or group 2 (545 [476; 605] ng/ml) (p<0,05 for all). Lp (a) was lower in the control group (14,5 [5,5; 36,0] mg/dl) than in group 1 (24,9 [9,7; 58,4] mg/dl) (p<0,005) and group 2 (23,8 [9,9; 75,7] mg/dL) (p<0,05). According to the logistic regression, an increased ATX level, regardless of age and other risk factors, was associated with degenerative AoS only in patients with CAD, while age and neutrophil to lymphocyte ratio were associated with the development of degenerative AoS both in patients with CAD and the general group.Conclusion. An elevated Lp (a) level is associated with CAD regardless of the aortic valve involvement, while an increased concentration of ATX and neutrophil to lymphocyte ratio in patients with CAD were associated with degenerative AoS regardless of age and other risk factors.