Specific Removal of C-Reactive Protein by Apheresis in a Porcine Cardiac Infarction Model

Abstract

it is possible to conduct apheresis at the following 2 days after acute myocardial infarction in a porcine infarction model and to analyze the infarct by cardiovascular magnetic resonance imaging at day 1 and 14. Copyright © 2010 S. Karger AG, Basel C-reactive protein (CRP), a classical acute phase protein, has been extensively studied as a systemic marker of inflammatory processes. During acute myocardial infarction (AMI), the circulating CRP concentration increases and its level predicts the outcome of AMI [1][2][3] . However, there is still a controversy whether CRP is only a marker or a risk factor, contributing causative to myocardial damage after AMI.In rats, administration of human CRP after ligation of the coronary artery reproducibly enhanced infarct size by up to 40% [4,5] . They received 40 mg/kg of isolated pure human CRP by intraperitoneal injection 1 h after coro- Key WordsAcute myocardial infarction ؒ Acute phase protein ؒ Adsorber ؒ Apheresis ؒ C-reactive protein Abstract Background: C-reactive protein (CRP) is a possible causative factor of the destructive processes observed during the weeks after myocardial infarction. Methods: We developed a clinically relevant animal model including the removal of CRP from blood plasma utilizing a specific CRP adsorber and the visualization of the infarct scar in the living animal by cardiovascular magnetic resonance imaging as a tool to investigate the impact of CRP after acute myocardial infarction. Results: We describe the facets of this model system and kinetics of clinical blood parameters like CRP and troponin. In addition, we demonstrate the potency of CRP apheresis reducing CRP levels by ϳ 70% in the established treatment system. Conclusion: We showed for the first time that

In vivo porcine lipopolysaccharide inflammation models to study immunomodulation of drugs

“…As CRP is a major APP in humans and numerous animal species, several species-specific porcine CRP ELISA kits are commercially available. To illustrate the need for careful interpretation, it should be remarked that Slagman et al (2011) considered the results of one CRP ELISA highly controversial.…”

PentraSorb C‐Reactive Protein: Characterization of the Selective C‐Reactive Protein Adsorber Resin

“…We have shown in a porcine infarction model that endogenous CRP levels, which were induced by myocardial infarction, could be decreased by a specific CRP-adsorber prototype using extracorporeal apheresis (18). The significant reduction of circulating CRP led to smaller myocardial scar size and improved the left ventricular ejection fraction (19).…”

“…In order to show that selective CRP apheresis is a suitable therapy option after AMI, we established a porcine animal model for the removal of endogenous CRP, which was first induced by myocardial infarction itself. In this porcine infarction model, a specific CRP-adsorber was able to temporarily and significantly reduce the elevated endogenous plasma CRP levels by extracorporeal apheresis (18). Further, the selective CRP apheresis stopped the growth of the infarcted area and stabilized the cardiac output of the left ventricle (19).…”

Elevation of Plasma Copeptin in Acute Myocardial Infarction in Pigs is Related to Changes in Mean Arterial Blood Pressure but not to Myocardial Ischemia

“…A detailed description of experimental procedures has been published previously [8]. In the original experiment 10 female pigs were investigated [9].…”