LDL-apheresis reduces P-Selectin, CRP and fibrinogen -- possible important implications for improving atherosclerosis.

Although it is known that LDL-apheresis improves coronary artery stenosis (CAS) as well as ischemic limbs seen in patients with peripheral arterial occlusive disease (PAOD), the underlying mechanisms remain still unknown. LDL-apheresis might exert its favorable action through anti-inflammatory effects. We studied whether or not serum or plasma levels of P-selectin, high sensitivity C-reactive protein (hsCRP), monocyte chemoattractant protein-1 (MCP-1) or fibrinogen could be reduced in patients with PAOD before and after 10 sessions of LDL-apheresis. Sixteen patients (12 patients with hemodialysis, HD) with PAOD were enrolled in the present study. LDL-apheresis was carried out 10 times (treated plasma of 3000 mL) over 5 weeks. Serum levels of P-selectin were significantly reduced from 516 +/- 153 to 290 +/- 52 ng/mL before and after 10-sessions of LDL-apheresis, respectively (P < 0.05). Likewise, serum levels of hsCRP decreased from 9.118 +/- 2.649 to 5.587 +/- 2.445 mg/L (P < 0.01); and plasma fibrinogen levels statistically decreased from 196 +/- 9.82 to 149 +/- 7.97 mg/dL (P < 0.01), whereas serum levels of MCP-1 were not significantly changed. The favorable actions of LDL-apheresis might include anti-inflammatory effects, which could lead to an improvement of CAS and PAOD. Moreover, this intervention might be applicable for patients with atherosclerotic cardiovascular disorders, particularly in patients with HD.