Heparin-Induced Extracorporeal Fibrinogen/LDL Precipitation (HELP): A Promising Regimen for the Treatment of Vascular Diseases

Walzl, B.; Haas, Anton; Walzl, Manfred

doi:10.1177/000331979704801202

Cited by 9 publications

(10 citation statements)

References 13 publications

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“…Our Apheresis Center has reported a reduction of necrosis and prevention of major amputation in patients with angiopathic diabetic foot, who underwent treatment with a HELP course 81 . The reduction of whole blood as well as of plasma viscosity and red cell transit time after the HELP treatment have been shown to lead to significant improvement on the Mathew Neurological Scale, Mini Mental State Examination and Activities-of-Daily-Living Test in thirty patients with cerebral multiinfarct dementia 82 . In addition to that, there is evidence of antioxidative effects of HELP treartment 83 .…”

Section: Introductionmentioning

confidence: 99%

COVID-19 and Therapeutic Apheresis

et al. 2022

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The COVID-19 pandemic, caused by the SARS-CoV-2 virus, is an unprecedented challenge for the global community. The pathogenesis of COVID-19, its complications and long term sequelae (so called Long/Post-COVID) include, in addition to the direct virus-induced tissues injury, multiple secondary processes, such as autoimmune response, impairment of microcirculation, and hyperinflammation. Similar pathological processes, but in the settings of neurological, cardiovascular, rheumatological, nephrological, and dermatological diseases can be successfully treated by powerful methods of Therapeutic Apheresis (TA). We describe here the rationale and the initial attempts of TA treatment in severe cases of acute COVID-19. We next review the evidence for the role of autoimmunity, microcirculatory changes and inflammation in pathogenesis of Long/Post COVID and the rationale for targeting those pathogenic processes by different methods of TA. Finally, we discuss the impact of COVID-19 pandemic on patients, who undergo regular TA treatments due to their underlying chronic conditions, with the specific focus on the patients with inherited lipid diseases being treated at the Dresden University Apheresis Center.

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Section: Introductionmentioning

confidence: 99%

COVID-19 and Therapeutic Apheresis

et al. 2022

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“…The side effect of the method most frequently reported was angina pectoris due to the presence of CAD. The second most observed side effect was vagal reflex, also described in other extracorporeal procedures (10,21). Side effects were reported for only 2.9% of the treatments (10).…”

Section: Discussionmentioning

confidence: 83%

Six years of treatment with the HELP system of a patient with familial hypercholesterolemia

Nascimento

Pasqual

Santos

et al. 2002

Braz J Med Biol Res

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The purpose of the present report is to demonstrate the long-term efficacy and safety of heparin-induced extracorporeal lipoprotein precipitation (HELP) of LDL-c and fibrinogen in the management of familial hypercholesterolemia. From June 1992 to June 1998 a 22-year-old young male patient with familial hypercholesterolemia (double heterozygote for C660X and S305C) resistant to medication and diet and with symptomatic coronary artery disease (angina) was treated weekly with 90-min sessions of the HELP system. The patient had also been previously submitted to right coronary artery angioplasty. The efficacy of the method was evaluated by comparing the reduction of total cholesterol, LDL-c and fibrinogen before and after the sessions and before and after initiation of the study (data are reported as averages for each year). During the study, angina episodes disappeared and there were no detectable adverse effects of the treatment. Total cholesterol (TC), fibrinogen, and LDL-c decreased significantly after each session by 59.6, 66.1 and 64%, respectively. HDL-c showed a nonsignificant reduction of 20.4%. Comparative mean values preand post-treatment values in the study showed significant differences: TC (488 vs 188 mg/dl), LDL-c (416.4 vs 145 mg/dl), and fibrinogen (144.2 vs 57.4 mg/dl). There was no significant change in HDL-c level: 29.4 vs 23 mg/dl. These data show that the HELP system, even for a long period of time, is a safe and efficient mode of treatment of familial hypercholesterolemia and is associated with disappearance of angina symptoms.

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“…For organizational reasons, this procedure was substituted by direct adsorption of lipoproteins (DALI) 9 for 2 treatment sessions and then stopped because of an apparent hypersensitivity reaction. For the remaining 10 months of the apheresis treatment period, heparin-induced extracorporeal low-density lipoprotein precipitation (HELP) 10,11 was used, which was well tolerated.…”

Section: Case Report and Methodsmentioning

confidence: 99%

A Child With Night Blindness

et al. 2011

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Refsum disease is a genetic progressive neurological disorder caused by neurotoxic phytanic acid, a nutritional component patients are unable to metabolize. Symptoms include retinopathy, polyneuropathy, ataxia, and deafness. They are variable and rarely recognized before adulthood. The authors report the case of a 14-year-old girl diagnosed because of night blindness. They treated her with a phytanic acid-poor diet and extracorporeal lipid apheresis. They used different methods over a 30-month period. Thereafter, the patient was treated with diet only. Membrane filtration and heparin-induced extracorporeal low-density lipoprotein precipitation apheresis were well tolerated. Withdrawal of phytanic acid was studied quantitatively. During a 5-year period, blood phytanic acid levels decreased to a noncritical range. The patient remained free of ophthalmological and neurological progression for a total observation of 12 years. Early diagnosis and effective measures to keep the phytanic acid load low can probably prevent the serious sequelae of Refsum disease. Developing a method for newborn screening is desirable.

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Heparin-Induced Extracorporeal Fibrinogen/LDL Precipitation (HELP): A Promising Regimen for the Treatment of Vascular Diseases

Cited by 9 publications

References 13 publications

COVID-19 and Therapeutic Apheresis

COVID-19 and Therapeutic Apheresis

Six years of treatment with the HELP system of a patient with familial hypercholesterolemia

A Child With Night Blindness

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