Impact of LDL-apheresis on inflammation and microcirculation

Abstract

Lipid-apheresis (LIPID-A) is highly effective in reduction of pro-atherosclerotic LDL-cholesterol and lipoprotein (a). It has been demonstrated in prospective and retrospective analyses to reduce major cardiovascular events. In addition to improvement of pro-atherosclerotic lipoprotein milieu, LIPID-A exerts pleiotropic effects on inflammation and micro-circulation. Several pro-inflammatory cyto- and chemokines as well as adhesion molecules are cleared by distinct LIPID-A methods. Moreover, a single LIPID-A can induce proliferative activity of circulating endothelial progenitor cells and by this way, enhance vascular repair capacity. Microcirculation is modified by LIPID-A by influencing the balance of vasoconstrictory and -dilatative mediators, plasma viscosity and erythrocyte aggregation resulting in an activation of functional capillary reserve and blood flow.