Effects of selective LDL apheresis on plasma concentrations of ICAM-1, VCAM-1 and P-selectin in diabetic patients with arteriosclerosis obliterans and receiving maintenance hemodialysis

Utsumi, Kouichi; Kawabe, Mitsuhiko; Hirama, Akio; Ueda, Kae; Kamada, Yuko; Arii, Kazumasa; Komaba, Yuichi; Katsura, Ken‐ichiro; Iino, Yuichi; Katayama, Yasuo

doi:10.1016/j.cca.2006.09.026

Cited by 33 publications

(20 citation statements)

References 11 publications

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“…There is also evidence that LA reduces the susceptibility of LDL to in vitro oxidation in diabetic patients undergoing hemodialysis [54]. The evidence that LA reduces P-selectin, hsCRP [36] or VCAM-1 [39], in addition to the mechanisms described above, shows that LA may be of clinical importance for preventing atherosclerotic conditions as well as diabetic macroangiopathy.…”

Section: La In Diabetic Nephropathymentioning

confidence: 92%

“…Beer et al reported that low-density lipoprotein and very low-density lipoprotein are selectively bound by aggregated C-reactive protein [38]. There is also evidence [39] that LA decreases soluble ICAM-1 or VCAM-1, indicating that endothelial dysfunction is improved. Thus, LA may be of wide application for treating chronic low-grade inflammation.…”

Section: Anti-inflammatory Effects and Atherosclerosismentioning

confidence: 94%

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Applications of LDL-apheresis in nephrology

Kobayashi

2008

Clin Exp Nephrol

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LDL-apheresis (LA) was originally used for familial hyperlipidemia, and then in Japan extended to use for the treatment of patients with peripheral arterial disease (PAD) and nephrotic syndrome due to steroid-resistant focal glomerular sclerosis (FGS). The reason why this treatment is applicable for these disorders is due to the fact that LA exerts its favorable effects beyond the lipid-lowering effect. The main underlying mechanisms, for example, in the case of LA application in patients with PAD are: (1) improvement of hemorheology, (2) improvement of endothelial dysfunction, (3) elevations of serum levels of NO and bradykinin, (4) increase in serum levels of vascular endothelial growth factor, and (5) reduction of adhesion molecules on monocytes. Furthermore, we have reported that LA could have anti-inflammatory effects because LA reduces serum levels of P-selectin, which is known to play an important role in the development of atherosclerosis as well as a reduction of serum C-reactive protein levels as standard biomarker of atherosclerosis. Massive proteinuria is also an important challenge in nephrology. The possible mechanisms besides removal of toxic lipids are the reduction of the vasoconstrictive prostanoid and thromboxane A2 (TXA2) and an improvement in macrophage function evidenced by a significant amelioration of interleukin-8 production by lipopolysaccharide-stimulated peripheral blood mononuclear cells. It is intriguing to note that in terms of pharmacodynamics, LA improves steroid and cyclosporine uptake into lymphocytes. Although there are no randomized controlled trials, it is clear that LA has various effects beyond lowering lipids. Making the device more concise and changing it into a whole blood adsorption type, we need to collect more clinical cases and to study the underlying mechanisms further.

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Section: La In Diabetic Nephropathymentioning

confidence: 92%

Section: Anti-inflammatory Effects and Atherosclerosismentioning

confidence: 94%

Applications of LDL-apheresis in nephrology

Kobayashi

2008

Clin Exp Nephrol

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“…Increased levels of soluble adhesion molecules have previously been reported in hemodialysis patients [19][20][21][22], but the significance of circulating soluble adhesion molecules as predictors of VAT remains largely unknown. Adhesion of leukocytes to the vascular endothelium is one of the most important key events in the development of atherosclerosis.…”

Section: Introductionmentioning

confidence: 98%

Soluble adhesion molecules as markers of native arteriovenous fistula thrombosis in children on uremia

Fadel

Elshamaa²,

Nabhan³

et al. 2014

Blood Coagulation &Amp; Fibrinolysis

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Vascular access represents a lifeline for children undergoing hemodialysis. A failure of vascular access among patients receiving regular hemodialysis is associated with increased morbidity, mortality and costs. We assessed the possibility of using soluble adhesion molecules as reliable predictors of vascular access failure in children on hemodialysis. Moreover, we evaluated whether there is an association among the different studied adhesion molecules in hemodialysis patients with thrombosed and non-thrombosed arteriovenous fistula fistulas (AVFs). This study included 55 hemodialysis children, 36 with good access and 19 with access failure, and 20 healthy volunteers. Forty-four patients had native AVFs and 11 patients had tunneled permanent catheter (11with thrombosed and 33 with non-thrombosed AVFs). Serum-soluble vascular cell adhesion molecule-1 (sVCAM-1), soluble intercellular adhesion molecule-1 (sICAM-1), soluble E-selectin (sE-selectin) and soluble P-selectin (sP-selectin) were measured using ELISA technique. A significant increase was found in the levels of sVCAM-1, sICAM-1, sE-selectin and sP-selectin versus controls and all hemodialysis patients, hemodialysis patients with good access and hemodialysis patients with access failure (P=0.001 for sVCAM-1 and sICAM-1 and P=0.0001 for sE-selectin and sP-selectin). A significant increase was found in the levels of sVCAM-1, sE-selectin and sP-selectin in both chronic hemodialysis patients with thrombosed and non-thrombosed native AVFs versus controls (P=0.0001 for all parameters). There was significant difference between both chronic hemodialysis patients with thrombosed and non-thrombosed native AVFs as regard to sVCAM-1 (54.64±30.82 versus 25.69±27.96ng/ml, P=0.04). Both sICAM-1 and sP-selectin were positively correlated with the erythropoietin (EPO) dose in hemodialysis children (r=0.31, P=0.04 and r=0.32, P=0.04, respectively). A significant positive association was found between E-selectin and sP-selectin in hemodialysis patients with thrombosed AVFs (r=0.83, P=0.04). There was a significant correlation between sVCAM-1 and EPO dose in thrombosed AVF group (r=0.84, P=0.01). The assessment of serum sVCAM-1 might be useful for the identification of the chronic hemodialysis patients at an increased risk for native AVFs thrombosis. The role of EPO in vascular access failure should be taken into consideration. The clinical relevance of these observations warrants further investigations.

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“…8,9) Utsumi, et al demonstrated that LDL-apheresis reduced adhesion molecules and inflammatory cytokines in diabetic patients with PAOD. 10) It is possible that LDL-apheresis enhances angiogenesis and attenuates inflammatory response in patients with PAOD, and thus, postoperative LDL-apheresis may play a promising role in developing the long-term patency for PAOD patients with poor peripheral vascular bed.…”

Section: Case Reportmentioning

confidence: 99%

Hybrid Revascularization for Critical Limb Ischemia Triggered by Multiple Organ Dysfunction Due to Acute Pneumonia; Urgent Catheter Intervention Followed by Low-Density-Lipoprotein Apheresis and Elective Peripheral Bypass Surgery

Hayashi

Mizuguchi

Takayama

2014

Annals of Vascular Diseases

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A 66-year-old man was referred for treatment of critical limb ischemia arising with multiple organ dysfunction due to acute pneumonia. Angiographic examinations demonstrated total obstruction of the bilateral external iliac arteries and the bilateral superficial femoral arteries with collateral circulation to the distal vessels. Urgent percutaneous transluminal angioplasty dissolved the obstruction of the left external iliac artery, and subsequent low-density-lipoprotein apheresis ameliorated his progressive ischemia in the lower extremities. Femorofemoral and bilateral femoro-popliteal bypasses were performed 31 days after the endovascular intervention, which achieved successful limb salvage with the relief of ischemic symptoms related to arteriosclerotic obliterans.

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Effects of selective LDL apheresis on plasma concentrations of ICAM-1, VCAM-1 and P-selectin in diabetic patients with arteriosclerosis obliterans and receiving maintenance hemodialysis

Cited by 33 publications

References 11 publications

Applications of LDL-apheresis in nephrology

Applications of LDL-apheresis in nephrology

Soluble adhesion molecules as markers of native arteriovenous fistula thrombosis in children on uremia

Hybrid Revascularization for Critical Limb Ischemia Triggered by Multiple Organ Dysfunction Due to Acute Pneumonia; Urgent Catheter Intervention Followed by Low-Density-Lipoprotein Apheresis and Elective Peripheral Bypass Surgery

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