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

Suzuki, Toshihide; Sato, Yuichi; Niizuma, Shinichiro; Kushiro, Toshio; Tani, Shigemasa; Ishikawa, Kazunobu; Nagao, Keisuke; Kanmatsuse, Katsuo; Ikeda, Hironori; Takahashi, Motoichirou; Kojima, Sunao

doi:10.1002/jca.20138

Cited by 5 publications

(8 citation statements)

References 12 publications

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“…Patients carrying genotype TT showed higher LDL levels compared to those carrying the genotype AA. LDL can raise the risk of ASO [33][34][35], and the genotype-phenotype analysis indicates that CARD8 rs2043211 polymorphism is associated with LDL levels, which further proves the association between CARD8 rs2043211 polymorphism and susceptibility to ASO.…”

Section: Discussionmentioning

confidence: 66%

The Association between Polymorphism of CARD8 rs2043211 and Susceptibility to Arteriosclerosis Obliterans in Chinese Han Male Population

Zhang

Song

et al. 2017

Cell Physiol Biochem

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Background and aims: Cholesterol crystals have been shown to cause inflammation. As a response to cholesterol crystal accumulation, the NLRP3 inflammasome is activated to produce IL-1β which eventually leads to atherosclerotic lesions. As a part of innate immunity, CARD8 is involved in the modulation of above mentioned inflammatory activities. The primary objective of this study was to investigate the association between polymorphism of CARD8 rs2043211 and susceptibility to arteriosclerosis obliterans (ASO) in Chinese Han male population. Methods: 758 male arteriosclerosis obliterans patients and 793 male controls were genotyped for rs2043211 with the TaqMan allele assays. Fasting blood-glucose (FBG), total cholesterol (TC), triglycerides (TG), urea nitrogen, creatinine, Serum uric acid, high density lipoprotein, low density lipoprotein, ALT, AST, and IL-1β in the blood were detected for all subjects. Clinical data were recorded to analyze the genotype-phenotype. Independent samples t-test was used to perform the comparisons between two groups. Odds ratios (ORs) with 95% confidence intervals (CIs) were calculated to measure the strength of relationship in the genotype distribution and allele frequencies between patients and controls. The analysis of variance was used for a genotype-phenotype analysis of the ASO patients. Results: The genotypic and allelic frequencies in the ASO group were significantly different from that in the control group (P = 0.014 by genotype, P = 0.003 by allele). Those carrying the genotype TT had a higher risk for ASO than those carrying the genotype AA (OR = 1.494, 95%CI1.131-1.974, P = 0.005).The difference was also significant after the adjustment for the history of smoking, TC, LDL, fasting blood glucose, systolic blood pressure and BMI(OR = 1.525, 95%CI1.158-2.009, P = 0.003). Conclusion: Our finding suggests that the polymorphism of CARD8 rs2043211 is probably associated with the development of ASO in Chinese Han male population.

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Section: Discussionmentioning

confidence: 66%

The Association between Polymorphism of CARD8 rs2043211 and Susceptibility to Arteriosclerosis Obliterans in Chinese Han Male Population

Zhang

Song

et al. 2017

Cell Physiol Biochem

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“…In patients with peripheral arterial disease the clinical symptoms can be improved by LDL apheresis [28,29]. Even after heart transplantation a single HELP apheresis increases myocardial perfusion measured by PET [4].…”

Section: Effects Of Ldl Apheresis On the Vascular Systemmentioning

confidence: 99%

Comparison of different LDL apheresis methods

Julius¹,

Frind

Tselmin

et al. 2008

Expert Review of Cardiovascular Therapy

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This article presents the generally accepted indications for LDL apheresis treatment. The available LDL apheresis methods differ with respect to acute relative reductions of LDL cholesterol; mean values after the LDL apheresis treatments are not different. Serum triglycerides, HDL-cholesterol, and lipoprotein(a) are also acutely reduced. Available LDL apheresis methods differ with respect to their impact on the coagulation system, on C-reactive protein and on leukocyte count. Cardiovascular events are clearly reduced by the LDL apheresis methods. There is an urgent need to prospectively compare the different LDL apheresis methods taking into account hard end points. The lower target values for LDL cholesterol suggested by international guidelines for high-risk patients will certainly require a more widespread use of LDL apheresis.

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“…Preferable response of skin lesion to LDL‐A was speculated that skin tissue can develop collateral arteries . Indeed, collateral development in ischemic lower extremities after LDL‐A treatment was reported . Secondly, statin therapy was proposed to stabilize cholesterol‐rich atherosclerotic plaques responsible for generating cholesterol crystal emboli .…”

Section: Discussionmentioning

confidence: 99%

Low‐Density Lipoprotein Apheresis Ameliorates Renal Prognosis of Cholesterol Crystal Embolism

2015

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Drugs such as corticosteroids and statins have been used to treat cholesterol crystal embolism (CCE), but the prognosis remains poor. This study evaluated the efficacy of low-density lipoprotein apheresis (LDL-A) in patients with CCE. Patients with CCE who showed renal deterioration after vascular interventions were studied retrospectively. Information on demographic variables, clinical measurements, and medication use was collected. The outcomes were incidence of maintenance dialysis and mortality at 24 weeks. A total of 49 patients with CCE were included, among whom 37 (76%) were diagnosed pathologically and the remainder were diagnosed clinically. The median estimated GFR at baseline and at diagnosis were 40.5 and 13.4 mL/min per 1.73 m(2) , respectively. Corticosteroids were used in 42 patients (86%), statins in 30 patients (61%), and angiotensin-converting enzyme inhibitors and angiotensin receptor blockers in 29 patients (59%). LDL-A was performed in 25 patients (LDL-A group), and not in 24 patients (control group). Smoking (100% vs. 72%, P = 0.02), white blood cell count (8900/mm(3) vs. 7000/mm(3) ) and corticosteroid use (96% vs. 75%) were higher in the LDL-A group compared with the control group, but there were no differences in other demographic and clinical parameters between the groups. Patients in the LDL-A group had a lower incidence of maintenance dialysis (2/25 (8%) vs. 8/24 (33%), P < 0.05), and a trend towards lower mortality (2/25 (8%) vs. 7/24 (29%), P = 0.074). These results suggest that LDL-A decreases the risk of maintenance dialysis in severe renal CCE patients after vascular interventions.

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

Cited by 5 publications

References 12 publications

The Association between Polymorphism of CARD8 rs2043211 and Susceptibility to Arteriosclerosis Obliterans in Chinese Han Male Population

The Association between Polymorphism of CARD8 rs2043211 and Susceptibility to Arteriosclerosis Obliterans in Chinese Han Male Population

Comparison of different LDL apheresis methods

Low‐Density Lipoprotein Apheresis Ameliorates Renal Prognosis of Cholesterol Crystal Embolism

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