engleski

Effects of LDL-apheresis therapy on antibodies against oxidizes LDL

LDL oxidation is considered a key event in the initiation of atherosclerosis. Measurement of the plasma level of autoantibodies to oxLDL might assess the impact of LDL oxidation in vivo. The aim of this study was to evaluate the effect of long-term LDL-apheresis on oxLDL autoantibodies (oxLDLab) generation and fluctuation. A patient suffering from severe combined hyperlipidemia underwent LDL-apheresis biweekly and was followed for two years. The oxLDLab titer was influenced by apheresis and showed a dynamic change. Contrary to what might be expected and although LDL level was markedly decreased, oxLDLab rose after each treatment. Thus, oxLDLab pre- (48.2ą4.8 AcU/ml) and post-apheresis (70.8ą8.7 AcU/ml) differed significantly in the first six-month period (p<0.0002), since the mean circulating post- treatment oxLDLab level was higher by 48%. This apparent paradox may have resulted from possible partial linkage of oxLDLab in the oxLDL-immune complexes masking the free antibodies and making them undetectable by ELISA. In the second six months of the same year, mean oxLDLab pre- (41.3ą5.8 AcU/ml) and post-apheresis (59.3ą7.5 AcU/ml) was lower, with a less significant difference (p<0.05). The titers of circulating oxLDLab were significantly lower in the second year of LDL-apheresis application (18mo: 34.6ą9.8 vs 37.4ą7.8 AcU/ml, NS ; 24mo: 30.3ą5.9 vs 33.9ą9.9 AcU/ml, NS), whereas differences between the pre- and post-treatment were not significant. However, if the level of oxLDLab is followed throughout the study, the curve shows a continuous decline, which denotes a regression of the autoantibody production. In parallel to changes in this biochemical parameter, regression of numerous xanthomas was clinically observed. In conclusion, our findings provide evidence that long-term LDL- apheresis treatment decreases the production of autoantibodies against oxLDL. This is an additional benefit of LDL-apheresis therapy, since minimalization of oxidized LDL and oxLDLab production reduces their involvement in the atherosclerotic processes.

Oxidized-LDl; Autoantibodies; LDL-apheresis

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