Changes in Coagulation Factors by Passage through a Dextran Sulfate Cellulose Column during Low-Density Lipoprotein Apheresis

Kojima, Sunao; Harada‐Shiba, Mariko; Toyota, Yasushi; Kimura, G; Tsushima, Motoo; Kuramochi, Morio; Sakata, Toshiyuki; Uchida, Kagehiro; Yamamoto, Akira; Omae, T

doi:10.1177/039139889201500309

Cited by 43 publications

(26 citation statements)

References 12 publications

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“…As to the former, the concomitant reduction of oxidized LDL could result in the reduction of circulating inflammatory cytokines and chemokines and suppression of intraglomerular invasion of macrophages which sometimes form foam cells, trapping the abnormally increased circulating lipoproteins [10]. As to the latter, improving hypercoagulability by reduction of coagulation factors [12, 13]and correcting the high tonus of renal vascular beds by reducing vasoconstrictive eicosanoids can be considered.…”

Section: Discussionmentioning

confidence: 99%

Significantly Rapid Relief from Steroid-Resistant Nephrotic Syndrome by LDL Apheresis Compared with Steroid Monotherapy

Muso

Mune²,

Fujii

et al. 2001

Nephron

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Rapid amelioration of hypercholesterolemia by LDL apheresis (LDL-A) was performed for long-standing nephrotic syndrome (NS) with hyperlipidemia due to focal segmental glomerulosclerosis (FGS) and the clinical data and prognosis were compared between LDL-A-treated and nontreated groups. Seventeen steroid-resistant NS patients treated with LDL-A (LDL-A group) and 10 NS patients treated with steroids only (steroid-monotherapy (SM) group) were compared. Serum cholesterol and phospholipid levels were significantly lowered only in the LDL-A group (p < 0.01, respectively). The LDL-A group showed a significant decrease of urinary protein (UP, p < 0.01) and increase of serum albumin (p < 0.05). Average time needed to achieve a decrease of UP to less than nephrotic range (< 3.5 g/day) was significantly shorter in the LDL-A group than in the SM group (p < 0.01). Although this is not a prospective study, it is highly expected that a rapid improvement of hypercholesterolemia by LDL-A in steroid-resistant NS will provide more rapid relief from NS than steroid therapy alone.

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Section: Discussionmentioning

confidence: 99%

Significantly Rapid Relief from Steroid-Resistant Nephrotic Syndrome by LDL Apheresis Compared with Steroid Monotherapy

Muso

Mune²,

Fujii

et al. 2001

Nephron

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“…Mii This finding appeared to reflect effects of LDL-A other than those on lipids. This view has been supported by reports that in addition to effects on lipids, LDL-A has diverse other effects, including improvement of blood rheology [8,9], improvement in erythrocyte deformation [10], reduction of fibrinogen [11], increased production of nitric oxide and bradykinin [12], reduction of oxidative stress through effects on vascular endothelial function [13], reduction of adhesion molecules [14], and effects on vascularization factors [6,15].…”

Section: Discussionmentioning

confidence: 85%

Efficacy of low‐density lipoprotein apheresis in arteriosclerosis obliterans of the lower extremities: Two cases with marked alleviation of clinical symptoms

Suzuki

Sato

Niizuma

et al. 2007

J of Clinical Apheresis

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We have recognized marked effectiveness for intermittent claudication with low-density lipoprotein (LDL) apheresis in two cases of arteriosclerosis obliterans (ASO). The Case 1 was a 73-year-old man with intermittent claudication of both lower extremities (Fontaine class II), digital subtraction angiography (DSA) revealed complete obstruction of the left common iliac artery, formation of a collateral to the peripheral portion of the left common iliac artery, and diffuse stenosis of the peripheral portion of the right common iliac artery. Ten sessions of LDL apheresis (LDL-A) improved the walking distance from 100 m before to 600 m after LDL-A treatment. The Case 2 was a 61-year-old man with intermittent claudication of the left lower extremity (walking distance: 200 m) began at 59 years. DSA revealed diffuse stenosis of the peripheral portion of the left popliteal artery. Ten sessions of LDL-A improved the walking distance from 200 m before to 800 m after LDL-A. At one month after the end of LDL-A treatment, DSA revealed formation of collateral to the peripheral portion of the left popliteal artery. Our findings suggest that LDL-A combined with drug treatment is safe and useful for the treatment of ASO, especially walking distance improved with short term treatment.

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“…The efficacy of LDL apheresis for patients with PAOD has been suggested by several lines of evidence [8,9,10,11,12,13,14,15,16,17,18,19]. Clinical evidence has suggested the following as mechanisms of the improvement of clinical symptoms in PAOD patients.…”

Section: Discussionmentioning

confidence: 99%

“…Acute and drastic lowering of serum lipid levels could improve blood rheology by reducing blood viscosity [9] or improving red-cell deformability [10]. In addition, significant reductions of plasma fibrinogen and coagulation factors such as von Willebrand factor [11, 12] could improve peripheral circulation. Generation of bradykinin [13] or nitric oxide [14, 15], elevated production of PGI 2 by vascular cells [16], reduction of adhesion molecule expression on mononuclear cells [17], and improvement of endothelium-dependent vasodilation can occur with a single session of LDL apheresis [14].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Low-Density Lipoprotein Apheresis in Patients with Peripheral Arterial Occlusive Disease Undergoing Hemodialysis Treatment

et al. 2007

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Background: Low-density lipoprotein (LDL) apheresis is effective in the treatment of peripheral arterial occlusive disease (PAOD). In the present study, we attempted to determine whether LDL apheresis is effective even for PAOD patients undergoing hemodialysis, who tend to be refractory to any treatment, and if so, to determine the mechanism of its efficacy. Methods: Serum levels of lipids and vascular growth factors, leg symptom, and endothelium-dependent vasodilation were investigated before and after 10 sessions of LDL apheresis in 11 PAOD patients undergoing hemodialysis. Results: Serum levels of total cholesterol, LDL cholesterol, and triglyceride exhibited drastic reduction, which completely disappeared 4 weeks after the final apheresis. Resting leg pain was improved in 6 cases even 4 weeks after final apheresis. Endothelium-dependent vasodilation was significantly increased 4 weeks after final apheresis (1.6 ± 0.6 to 4.7 ± 1.0%, p < 0.05). Levels of vascular growth factors, hepatocyte growth factor and vascular endothelial growth factor were not changed during treatment. Conclusions: These findings suggested that LDL apheresis is effective even in PAOD patients undergoing hemodialysis. Our findings suggest that its mechanisms of efficacy include improvement of vascular endothelial dysfunction, in addition to drastic but acute reduction of lipid levels. Since PAOD patients undergoing hemodialysis tend to be resistant to any treatment and are at high risk for lower-extremity amputation, LDL apheresis could be a useful strategy for treatment of them.

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Changes in Coagulation Factors by Passage through a Dextran Sulfate Cellulose Column during Low-Density Lipoprotein Apheresis

Cited by 43 publications

References 12 publications

Significantly Rapid Relief from Steroid-Resistant Nephrotic Syndrome by LDL Apheresis Compared with Steroid Monotherapy

Significantly Rapid Relief from Steroid-Resistant Nephrotic Syndrome by LDL Apheresis Compared with Steroid Monotherapy

Efficacy of low‐density lipoprotein apheresis in arteriosclerosis obliterans of the lower extremities: Two cases with marked alleviation of clinical symptoms

Efficacy of Low-Density Lipoprotein Apheresis in Patients with Peripheral Arterial Occlusive Disease Undergoing Hemodialysis Treatment

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