Is the Efficacy of LDL Apheresis in Ischemic Optic Neuropathy Linked to a Reduction in Endothelial Activation Markers?

Ramunni, Alfonso; Ranieri, G.; Giancipoli, Giovanni; Guerriero, Silvana; Ria, Roberto; Saliani, M.T.; Sborgia, Luigi; Ranieri, P; Coratelli, P

doi:10.1159/000094574

Cited by 12 publications

(9 citation statements)

References 73 publications

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“…In subjects affected by ischemic optical neuropathy, a disease of the optical microcirculation, an improved visual acuity was demonstrated after 3 sessions of LDL apheresis, while a clinical improvement was evident already after the first session [18,19] .…”

Section: Discussionmentioning

confidence: 99%

Fibrinogen Apheresis in the Treatment of Peripheral Arterial Disease

Ramunni¹,

Brescia²,

Quaranta³

et al. 2007

Blood Purif

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Background: Fibrinogen is mainly responsible for determining the viscosity of whole blood. In peripheral arterial disease (PAD) the fibrinogen concentration seems to affect the microcirculation flow. Aim: To study the effects of an abrupt reduction of fibrinogen on the hemodynamics of the lower extremities and the clinical picture of patients with PAD. Methods: Ten patients affected by various stages of PAD underwent 1 session of fibrinogen apheresis (TheraSorb, Miltenyi Biotec, Germany). Laboratory parameters of endothelial activation were assessed before and after the session, as well as walking distance (WD), the ankle-brachial index and laser Doppler flowmetry. Results: A significant reduction in the laboratory parameters was observed: fibrinogen (50%), total cholesterol (18%), LDL cholesterol (24%), sE-selectin (23%), sICAM-1 (19%) and sVCAM-1 (10%). The procoagulant factors, factor VIII and von Willebrand factor, did not vary significantly. Both pain-free and total WD were significantly improved (p < 0.003 and p <0.006, respectively), the ankle-brachial index remained unchanged, and laser Doppler flowmetry showed a modest but not significant increase. Conclusions: Fibrinogen apheresis allowed us to study the effects of an acute modification of fibrinogen in PAD, on both some aspects of the endothelial function and on the hemodynamics, demonstrating an improvement of WD and a minimal increase in the skin microcirculation.

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Section: Discussionmentioning

confidence: 99%

Fibrinogen Apheresis in the Treatment of Peripheral Arterial Disease

Ramunni¹,

Brescia²,

Quaranta³

et al. 2007

Blood Purif

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“…LA has been shown not only to achieve a rapid, marked reduction in the cholesterol values but also to reduce the long-term incidence of cardiovascular events [16][17][18] . It has still to be seen how much this depends on the reduction of harmful cholesterol alone, and how much on the influence of pleiotropic effects: we have already attempted to verify this question in a disturbance of the ocular microcirculation [19] .…”

Section: Introductionmentioning

confidence: 99%

Effect of Low-Density Lipoprotein Apheresis on Circulating Endothelial Progenitor Cells in Familial Hypercholesterolemia

Ramunni

Brescia²,

Dambra³

et al. 2010

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Background: Long-term treatment with low-density lipoprotein (LDL) apheresis (LA) has been shown to reduce the incidence of cardiovascular events in patients affected by familial hypercholesterolemia (FH). Data from experimental studies suggest that circulating endothelial progenitor cells (EPCs) can repair the vascular lesions caused by atherosclerosis. Since a reduction of these cells has been demonstrated to predict atherosclerosis progression, the aim of this study was to verify whether LA can increase the percentage of EPCs. Methods: In 15 patients affected by FH periodically treated with LA, the percentage of EPCs was determined before and after performing LA, and compared with the values of 15 control subjects and 15 hypercholesterolemic patients treated with statins. Results: Significant differences were found in FH patients between the pre-apheresis percentages of CD34+/KDR+, defined as EPCs by a wide consensus of opinion, and the values found 24 h after the procedures (0.00868 ± 0.003 vs. 0.01009 ± 0.002%, p < 0.005). Instead, the percentages of CD34+/KDR+/CD133+, considered as an immature subset of EPCs, remained substantially unchanged. However, a significant reduction in the percentage of EPCs was observed in both patient groups as compared to the controls, at all the assessment times. Conclusion: In the short-term LA seems to stimulate mobilization of CD34+/KDR+ cells. Hypercholesterolemic patients show a lower percentage of EPCs than controls. There were no differences in the EPCs percentages between the 2 patients groups, despite the fact that LDL cholesterol levels were higher in the group undergoing LA.

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“…5 Moreover, an improvement in the MD was also observed in our previous experiences 4,5 following treatment with LDL apheresis, but we did not prolong follow-up to 6 months. In this study, the return of the MD to the pretreatment values suggests that the temporary increase in MD could be sustained by reversible haemorheological improvements (reduced plasma and whole blood viscosity, reduced erythrocyte aggregability, and so on) obtained using LDL apheresis, that could have induced a short-term enhanced blood flow to the posterior ciliary arteries.…”

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confidence: 55%

“…1,2 In previous experiences, we have associated treatment with LDL apheresis and traditional therapy in patients affected by NAION, obtaining convincing results in terms of the improvement of functional parameters. [3][4][5] In this study, 20 patients affected by NAION were randomly subdivided into two groups: a group of 10 patients treated with conventional therapy in combination with LDL apheresis (group 1) and a control group of 10 patients treated with conventional therapy only (group 2).…”

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confidence: 99%