Serum Amyloid A and P Protein Levels are Lowered by Dextran Sulfate Cellulose Low‐Density Lipoprotein Apheresis

Abstract

The present study describes the short-term effect of dextran sulfate cellulose (DSC) low-density lipoprotein (LDL) apheresis using a plasma separator equipped with a polysulfone (PS) membrane filter (PS/DSC-LDL apheresis) on the serum amyloid A (SAA) and P (SAP) protein levels during treatment in a patient with familial hypercholesterolemia (type IIa, heterozygote). PS/DSC-LDL apheresis markedly lowered both the SAA (reduction percentage, 84.1+/-8.2%) and SAP (91.4+/-5%) levels, which returned to their respective initial levels within 4 days. Experimentally, the levels of both proteins also decreased on passage through the DSC minicolumn without a PS membrane, indicating that the DSC resin had an affinity to both proteins. These results suggest that PS/DSC-LDL apheresis may be advantageous for amyloid protein accumulating disorders, including amyloidosis and atherosclerosis.

Lipoprotein apheresis

“…The diseases which have demonstrated some clinical improvement with lipoprotein apheresis and are now being studied in clinical trials include cerebrovascular disease, postcardiac transplant, acute coronary syndrome, diabetic ischemic foot, ocular microcirculatory disturbances, preeclampsia, sudden idiopathic hearing loss, and age-related macular degeneration [ ]. The reduction of these factors, in addition to apoB lipoproteins, is intricately connected with the acute and chronic 52]. Some markers, such as C-reactive protein, are acutely reduced following lipoprotein apheresis therapy and are able to maintain a long-term reduction in plasma levels [53].…”

“…SAA has potent proatherogenic properties that may alter HDL's biological functions involved with cholesterol efflux capacity and anti-inflammation [68 & ]. A single treatment of lipoprotein apheresis reduces SAA by more than 80% [52]. ApoE4 is associated with CVD and Alzheimer's disease [69,70].…”