Plasma Purification is Associated With Reduced Inflammation Factors and Down-regulation of Lipid Metabolic and ER Stress Proteins in Patients With Hyperlipidemia

Abstract

Background Hyperlipidemia is a strong risk factor for arteriosclerosis and cardiovascular disease (CVD). Lipid-lowering therapy using drugs often results in many side effects. The aim of our study is to investigate the potential effects of non-drug therapy by double filtration plasmapheresis (DFPP) on lipid metabolic, endoplasmic reticulum (ER) stress and apoptosis related proteins in peripheral blood mononuclear cells (PBMC) before and after lipid clear out in patients with hyperlipidemia. MethodsLipid metabolic [CD36, propotein convertase subtilisin/kexin type 9 (PCSK9) and LDL receptor], ER stress (GRP78, CHOP, ATF4, EIF2a) and apoptosis related (Bcl-2, BAX, and Caspase-3) proteins were assayed by western blot, reactive oxygen species (ROS) measured by flow cytometry (FCM) and serum inflammatory factors were detected by ELISA. Results35 patients with hyperlipidemia were selected into this study. Compared with pre-DFPP, most of lipid metabolic parameters as cholesterol, triglyceride, LDL, lipoprotein a [Lp(a)] and small dense LDL cholesterol (sdLDL) reduced. DFPP process was associated with the down-regulation of lipid metabolic, ER stress and apoptosis proteins, also resulted in the decrease in ROS and serum inflammatory factors release. Conclusion DFPP owns the capacity of lipid-lowering, also can regulate lipid metabolic, ER stress and apoptosis related proteins in PBMC and reduce inflammatory factors in patients with hyperlipidemia (ClinicalTrials.gov number, NCT03491956). Footnote: Xiao Meng Zhang and Hao Deng contribute equally to this paper.