Lipid apheresis: An in vivo application of plasma delipidation with organic solvents resulting in acute transient reduction of circulating plasma lipids in animals

Abstract

Despite primary and secondary prevention of coronary disease with lowering plasma cholesterol by diet and drug therapy, coronary heart disease remains the major cause of death in Western countries. Low density lipoprotein apheresis had the potential to make a significant impact as it acutely leads to a marked reduction in plasma cholesterol. However, recent preliminary results suggest that low density lipoprotein apheresis may not be more effective in preventing progression of coronary disease than current drug therapy. We have devised a new technique, termed lipid apheresis, which removes cholesterol and triglycerides from plasma but retains the apolipoproteins. This procedure shows great promise in stimulating regression beyond current therapy. Lipid apheresis, a new extracorporeal procedure based on plasma delipidation with the organic solvent mixture butanol-diisopropyl ether, was applied to hypercholesterolemic and normocholesterolemic roosters. Approximately 25% of the calculated blood volume was removed from the animals. The plasma was separated from the blood cells. The plasma was delipidated for 20 min with the organic solvent mixture. The delipidated plasma containing all proteins, including the apolipoproteins and other ionic constituents, was remixed with the blood cells and infused back into the identical donor animals. Analyses of serial blood samples collected from lipid apheresed and sham treated animals up to 16 h after infusion revealed that lipid apheresis caused acute, marked reductions in plasma lipids. The pattern and extent of the plasma levels of cholesterol were different in the hypercholesterolemic animals when compared with normocholesterolemic animals, indicating that a readily extraplasma cholesterol pool in the hypercholesterolemic animals was rapidly mobilized into the plasma pool.(ABSTRACT TRUNCATED AT 250 WORDS)

Lecithin–cholesterol acyltransferase activity in normocholesterolaemic and hypercholesterolaemic roosters: modulation by lipid apheresis

“…The present study has investigated the effect of a recently described novel LA procedure [6] on LCAT activity, an important enzyme involved in reverse cholesterol transport. LCAT activities in pre-LA treated roosters are approximately 3 .…”

“…The LA procedure was performed as described previously [6]. Briefly, approximately 25% of the calculated blood volume was collected from a brachial vein of the animal with a 21-gauge needle and syringe.…”

“…We recently reported a new procedure for the extracorporeal removal of lipids, but not apolipoproteins, from plasma [6]. The attributes of this procedure as opposed to low-density lipoprotein (LDL) apheresis have been described previously [6].…”

“…The attributes of this procedure as opposed to low-density lipoprotein (LDL) apheresis have been described previously [6]. Essentially, lipid apheresis (LA) results in an acute reduction in circulating plasma cholesterol levels with no effect on apolipoproteins or biochemical or haematological parameters.…”

“…Thus, the objective of this study was to examine the relationship between the activity of LCAT and its substrates, lecithin (phosphatidylcholine) and unesterified cholesterol, in normocholesterolaemic and hypercholesterolaemic roosters that had been subjected to LA. The rooster was chosen for this study for a variety of reasons as discussed previously [6], but essentially because it can spontaneously develop a human-like atherosclerotic plaque when fed a cholesterol diet [10].…”