Pleiotropic Effect of Lipoprotein-Apheresis on the Soluble Form of Activated Leukocyte Cell Adhesion Molecule (sALCAM) in Familial Hypercholesterolaemia

Bauer, Rüdiger von; Oikonomou, Dimitrios; Sulaj, Alba; Kopf, Stefan; Fleming, Thomas; Rudofsky, Gottfried; Nawroth, Peter P.

doi:10.1055/a-0630-0232

Cited by 4 publications

(3 citation statements)

References 24 publications

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“…Recently in a randomized controlled cross-over trial in patients with refractory angina and increased Lp(a) levels, myocardial perfusion, atheroma burden, exercise capacity and symptoms were found to be improved with LA treatment [34]. In addition LA changes the plasma inflammatory profile and the cytokine pattern in patients with severe dyslipidemia, which may correspond to the early reduction of MACE and MANCE in Lp(a) patients [15,17,35,36]. Because of its assumed long circulation in the arterial vessels Lp(a) contains pro-inflammatory oxidized phospholipids (OxPL), which induce monocyte trafficking to the arterial wall and mediate pro-inflammatory responses through its OxPL content [32].…”

Section: Discussionmentioning

confidence: 98%

Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels

Schettler¹,

Neumann²,

Pristipino³

et al. 2019

Clin Res Cardiol Suppl

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Background Lipoprotein(a) (Lp(a)) is a genetic risk factor for cardiovascular disease (CVD) and is associated with the induction and sustaining of atherosclerotic cardiovascular diseases (ASCVD). Since 2008 Lp(a) along with progressive CVD has been approved as an indication for regular lipoprotein apheresis (LA) in Germany. The German Lipoprotein Apheresis Registry (GLAR) has been initiated to provide statistical evidence for the assessment of extracorporeal procedures to treat dyslipidemia for both LDL-cholesterol (LDL-C) and Lp(a). The GLAR now allows prospective investigations over a 5-year period about annual incidence rates of cardiovascular events. Here Lp(a) patients (LDL-C < 100 mg/dl; Lp(a) > 60 mg/dl or >120 nmol/l) showed the same reduction of major coronary (83%) and non-coronary events (63%) as had been formerly shown in the Pro(a)LiFe study. However, Lp(a) is not only an apolipoprotein(a) (apo(a)) and LDL-C containing particle, which is covalently bound to a LDL-C core by a disulphide bridge. The composition of this particle, inter alia containing oxidized phospholipids, gives pro-atherosclerotic, pro-inflammatory, and pro-thrombotic properties, inducing atherosclerotic processes mainly in the arterial wall. However, recent investigations have shown that a reduction of inflammatory settings without LDL-C or Lp(a) reduction may reduce ASCVD events. Lipoprotein apheresis (LA) could not only reduce LDL-C and Lp(a) in parallel, but also different inflammatory and coagulation parameters. In summary lipoprotein apheresis is not only anti-atherosclerotic, but also anti-inflammatory and anti-thrombotic and therefore an ideal treatment option with respect to the shown reduction of major adverse coronary events (MACE) and major adverse non-coronary events (MANCE) by reducing Lp(a) levels.Keywords Lipoprotein apheresis · Lipoprotein (a) · Cardiovascular disease · Coronary artery disease · Major coronary events · Major non-coronary events · Inflammation · Prevention This article is part of the special issue "Lp(a) -Update 2018"

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Section: Discussionmentioning

confidence: 98%

Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels

Schettler¹,

Neumann²,

Pristipino³

et al. 2019

Clin Res Cardiol Suppl

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“…While statins, ezetimibe and PCSK9 inhibitors all act by enhancing LDL receptor activity, MTP inhibitors such as lomitapide act independent of LDL receptor activity [34][35][36][37].…”

Section: Discussionmentioning

confidence: 99%

Management and clinical outcomes of patients with homozygous familial hypercholesteremia in Saudi Arabia

Kholaif

Mohamed

Alharbi

et al. 2023

Monaldi Arch Chest Dis

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We report the incidence, patient characteristic with clinical outcomes in patients with homozygous familial hypercholesterolemia (HoFH) in Saudi Arabia. This is a retrospective and prospective, single center study which included 37 patients 14 years and older enrolled and followed up between 2018-2021 for three years. 46% were females, 78% were offspring of consanguineous marriage. LDLR mutation was in 78% and LDL-C/LDLRAP in 3% of patients. Mean LDL-C at the first presentation was 14.2±3.7 mmol/L, average Dutch lipid score was 20.9±6.24. LDL apheresis was performed on 70% of patients. Most patients were on ezetimibe (92%), high-dose statins ( 84%) and PCSK9 inhibitors (32%). 48.6% had aortic stenosis, out of which 30% had severe aortic stenosis. Ten underwent aortic valve surgery (5 mechanical valve, 3 Ross procedure, 1 aortic valve repair, 1 bioprosthetic valve) and one had transcatheter aortic valve implantation (TAVI). Coronary artery bypass surgery (CABG) was performed on 32% and percutaneous intervention (PCI) on 11% of patients. HoFH patients have complex diseases with high morbidity and mortality, and benefit from a highly specialized multidisciplinary clinic to address their clinical needs. Although there are several therapeutic agents on the horizon, early diagnosis, and treatment of HoFH remain critical to optimize patient outcomes.

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“…LDL-C levels can be precisely decreased by this procedure, depending upon the treated plasma volume, when properly performed. Lipoprotein apheresis not only removes LDL but also has potential pleiotropic effects in preventing atherosclerosis through removal of cell adhesion molecules 54) , coagulation factors 55) , and inflammatory cytokines 56) . Lipoprotein apheresis for HoFH once every 1 to 2 weeks is covered by Japanese public healthcare insurance.…”

Section: Future Perspectivesmentioning

confidence: 99%

Homozygous Familial Hypercholesterolemia

Nohara

Tada

Ogura

et al. 2021

JAT

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Early diagnosis and initiation of lipid-lowering therapy is essential for preventing development of cardiovascular complications, even in Japan where cardiovascular disease is not the leading cause of death and its prevalence among FH patients seems to be somewhat lower than in Western countries. Heterozygous FH (HeFH) patients who carry the mutated gene in a single allele have plasma LDL cholesterol (LDL-C) levels double normal or higher and may experience the first cardiovascular event as

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Pleiotropic Effect of Lipoprotein-Apheresis on the Soluble Form of Activated Leukocyte Cell Adhesion Molecule (sALCAM) in Familial Hypercholesterolaemia

Cited by 4 publications

References 24 publications

Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels

Lipoprotein apheresis is an optimal therapeutic option to reduce increased Lp(a) levels

Management and clinical outcomes of patients with homozygous familial hypercholesteremia in Saudi Arabia

Homozygous Familial Hypercholesterolemia

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