Impact of selective LDL apheresis on serum chemerin levels in patients with hypercholesterolemia

Abstract

BackgroundSelective low-density lipoprotein (LDL) apheresis is commonly used to treat patients with familial hypercholesterolemia (FH). Chemerin is an adipokine with putative roles in the regulation of lipid metabolism.MethodsIn our pilot study, we measured serum chemerin levels by enzyme-linked immunosorbent assay in six severe heterozygous FH patients before and after their first LDL apheresis treatments using the technique of direct adsorption of lipoproteins (DALI).ResultsThe first treatment sessions decreased serum chemerin levels by an average of 27.26 %. While following one patient, 12 months of regular LDL apheresis resulted in a permanent reduction in his serum chemerin level. Changes in the lipoprotein subfractions measured by gel electrophoresis (Lipoprint) correlated with the reduction of chemerin levels. Furthermore, we eluted and then measured chemerin bound to the DALI column.ConclusionWe conclude that LDL apheresis decreases the circulating level of chemerin by binding the protein to the column and thus improves lipoprotein subfraction pattern.

The Role of Chemerin in Metabolic and Cardiovascular Disease: A Literature Review of Its Physiology and Pathology from a Nutritional Perspective

“…This suggests that chemerin is involved in the HDL maturing process [ 123 , 124 ]. LDL apheresis lowered circulating chemerin, implying that chemerin is bound, at least partly, to lipoproteins [ 125 ]. Future studies should investigate this possibility.…”

The Importance of Arterial Stiffness Assessment in Patients with Familial Hypercholesterolemia

“…In addition to that, it reduces the level of lipoprotein (a) (Lp(a)) [ 23 ], known as an individual cardiovascular risk factor also in FH patients [ 24 , 25 ], as well as very low-density lipoprotein levels (VLDL), also containing ApoB, by 70% [ 26 ]. During apheresis, the level of protein-like components causing cardiovascular diseases is decreased in the serum; thus, the treatment has an evidently beneficial anti-atherosclerotic impact [ 27 ]. The serum levels of inflammatory cytokines and oxidative stress are reduced [ 28 ].…”

Changes in serum afamin and vitamin E levels after selective LDL apheresis

“…Beyond its lipid lowering efficacy, LDL apheresis affects several pro‐ and anti‐inflammatory factors involved in the pathophysiology of human atherosclerosis including the complement cascade, the cytokine network and several other inflammatory mediators. Several studies demonstrated the benefits of LDL apheresis on these factors, most likely due to adsorption of the mediators to the columns . This could potentially confer additional benefits for these patients by decreasing the progression of arteriosclerosis, in addition to lowering their LDL cholesterol …”

“…Several studies demonstrated the benefits of LDL apheresis on these factors, most likely due to adsorption of the mediators to the columns. 5,6 This could potentially confer additional benefits for these patients by decreasing the progression of arteriosclerosis, in addition to lowering their LDL cholesterol. 7 Free radicals play an important role in the pathogenesis of atherosclerosis.…”