Control of Plasma HDL Levels After Plasmapheresis

  • G. R. Thompson
  • A. Jadhav
Part of the Advances in Experimetal Medicine and Biology book series (AEMB, volume 201)


Plasma exchange, or plasmapheresis, was first introduced for the treatment of homozygous familial hypercholesterolaemia more than 10 years ago (1), Since then it has become increasingly clear that twice monthly exchanges with plasma protein fraction (PPF) provide a safe and effective means of treating this potentially fatal condition. Several patients have undergone this regimen for over 9 years without any significant acute complications or long-term side-effects. Mean plasma cholesterol levels have been reduced to 50% of untreated values (2) and this has been accompanied by gradual disappearance of cutaneous and tendon xanthomata. However, there has been little evidence of regression of atheromatous lesions in the root of the aorta or coronary arteries, although the impression is that progression of such lesions has been arrested or slowed (3). Analysis of the life-span of 5 homozygous sibling pairs, one member of each being treated by plasma exchange and the other not, shows that this form of treatment improves the chances of survival (unpublished data).


HDL3 Cholesterol High Density Lipoprotein Cholesterol Plasma Exchange Serum Bile Acid Lecithin Cholesterol Acyl Transferase 
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  1. 1.
    G.R. Thompson, R. Lowenthal and N.B. Myant, Plasma exchange in the management of homozygous familial hypercholesterolaemia, Lancet 1:1208 (1975).PubMedCrossRefGoogle Scholar
  2. 2.
    G.R. Thompson, Plasma exchange for hypercholesterolaemia, Lancet 1:1246 (1981).PubMedCrossRefGoogle Scholar
  3. 3.
    G.R. Thompson, N.B. Myant, D. Kilpatrick, CM. Oakely, M.J. Raphael and R.E. Steiner, Assessment of long-term plasma exchange for familial hypercholesterolaemia, Brit. Heart J. 43:680 (1980).PubMedCrossRefGoogle Scholar
  4. 4.
    D.P. Barr, Some chemical factors in the pathogenesis of atherosclerosis, Circulation 8:641 (1953).PubMedCrossRefGoogle Scholar
  5. 5.
    G.S. Miller and N.E. Miller, Plasma-high-density-lipoprotein concentration and development of ischaemic heart disease, Lancet 1:16 (1975).PubMedCrossRefGoogle Scholar
  6. 6.
    K. Berg, A.L. Borresen and G. Dahlen, Serum-high-density-lipoprotein and atherosclerotic heart disease, Lancet 1:499 (1976).PubMedCrossRefGoogle Scholar
  7. 7.
    T. Ishikawa, N. Fidge, D.S. Thelle, O.H. Forde and N.E. Miller, The Tromso Heart Study: serum apolipoprotein AI concentration in relation to future coronary heart disease, Eur. J. Clin. Invest. 8:179 (1978).PubMedCrossRefGoogle Scholar
  8. 8.
    G.G. Rhoads, C.L. Gulbrandsen and A. Kagan, Serum lipoproteins and coronary heart disease in a population study of Hawaii Japanese men, New Eng. J. Med. 294:293 (1976).PubMedCrossRefGoogle Scholar
  9. 9.
    W.P. Castelli, J.T. Doyle, T. Gordon, C. G. Harnes, M.C. Hjortland, S.B. Hulley, A. Kagan and W.J. Zukel, HDL cholesterol and other lipids in coronary heart disease. The cooperative lipoprotein pheno-typing study, Circulation 55:767 (1977).PubMedCrossRefGoogle Scholar
  10. 10.
    S. Yaari, U. Goldbourt, Z. Even-Zohar and H.N. Neufeld, Associations of serum high density lipoprotein and total cholesterol with total, cardiovascular and cancer mortality in a 7-year prospective study of 10,000 men, Lancet 1:1011 (1981).PubMedCrossRefGoogle Scholar
  11. 11.
    P.J. Jenkins, R.W. Harper and P.J. Nestel, Severity of coronary atherosclerosis related to lipoprotein concentration, Brit. Med. J. 2:388 (1978).PubMedCrossRefGoogle Scholar
  12. 12.
    T.A. Pearson, B.H. Bulkley, S.C. Achuff, P.O. Kwiterovich and L. Gordis, The association of low levels of HDL cholesterol and arteriographically defined coronary artery disease, Amer. J. Epidem. 109:285 (1979).Google Scholar
  13. 13.
    J.J. Maciejko, D.R. Holmes, B.A. Kottke, A.R. Zinsmeister, D.M. Dinh and S.J.T. Mao, Apolipoprotein A-I as a marker of angiographically assessed coronary artery disease, New Eng. J. Med. 309:385 (1983).PubMedCrossRefGoogle Scholar
  14. 14.
    A. Angel, S. Thanabalasingham, D. Reichl, J.J. Pflug, G.R. Thompson and N.B. Myant, Effects of starvation and plasma exchange on lecithin: cholesterol acyltransferase activity and cholesterol efflux in cholesterol-fed pigs, Res. Exp. Med. 184:231 (1984).CrossRefGoogle Scholar
  15. 15.
    S. Thanabalasingham, G.R. Thompson, I. Trayner, N.B. Myant and A.K. Soutar, Effect of lipoprotein concentration and lecithin: cholesterol acyltransferase activity on cholesterol esterification in human plasma after plasma exchange, Eur. J. Clin. Invest. 10:45 (1980).PubMedCrossRefGoogle Scholar
  16. 16.
    O. Zierenberg, G. Assmann, G. Schmitz and M. Rosseneu, Effect of polyenephosphatidylcholine on cholesterol uptake by human high density lipoprotein, Atherosclerosis 39:527 (1981).PubMedCrossRefGoogle Scholar
  17. 17.
    A. Postiglione, B.L. Knight, A.K. Soutar and G.R. Thompson, Comparison of cholesterol efflux induced by exogenous phospholipid in vitro and during plasma exchange, in press.Google Scholar
  18. 18.
    C.W.M. Adams and Y.J. Abdulla, The action of human high density lipoprotein on cholesterol crystals. Part 1. Light-microscopic observations, Atherosclerosis 31:465 (1978).PubMedCrossRefGoogle Scholar
  19. 19.
    C.W.M. Adams, Y.H. Abdulla, O.B. Bayliss and R.S. Morgan, Modification of aortic atheroma and fatty liver in cholesterol-fed rabbits by intravenous injection of saturated and polyunsaturated lecithins, J. Path. Bact. 94:77 (1967).PubMedCrossRefGoogle Scholar
  20. 20.
    P. Dewailly, E. Decoopman, C. Desreumaux and J.C. Fruchart, Plasma removal of intravenous essential phospholipids in man, in “Phosphatidylcholine,” H. Peeters, ed., Springer Verlag, Berlin, pp 80–86 (1976).CrossRefGoogle Scholar
  21. 21.
    O. Stein and Y. Stein, The removal of cholesterol from Landschlitz ascites cells by high-density apolipoprotein, Biochem. Biophys. Acta 326:232 (1973).PubMedCrossRefGoogle Scholar
  22. 22.
    Y. Stein, M.C. Glangeaud, M. Fainaru and O. Stein, The removal of cholesterol from aortic smooth muscle cells in culture and Landschlitz ascites cells by fractions of human high-density apolipoprotein, Biochem. Biophys. Acta 380:106 (1975).PubMedCrossRefGoogle Scholar
  23. 23.
    M. Friedman, S.O. Byers and R.H. Rosenman, Resolution of aortic atherosclerotic infiltration in the rabbit by phosphatide infusion, Proc. Sco. Exp. Biol. Med. 95:586 (1957).Google Scholar
  24. 24.
    CL. Malmendier, C. Delcroix and J.P. Ameryckx, In vivo metabolism of human apoprotein A-I-phospholipid complexes. Comparison with human high density lipoprotein — apoprotein A-I metabolism, Clin. Chem. Acta 131:201 (1983).CrossRefGoogle Scholar
  25. 25.
    P-J. Lupien, S. Moorjani and J. Awad, A new approach to the management of familial hypercholesterolaemia: removal of plasma cholesterol based on the principle of affinity chromatography, Lancet 1:1261 (1976).PubMedCrossRefGoogle Scholar
  26. 26.
    W. Stoffel, H. Borberg and V. Greve, Application of specific extra-corporeal removal of low density lipoprotein in familial hypercholesterolaemia, Lancet 2:1005 (1981).PubMedCrossRefGoogle Scholar
  27. 27.
    S. Yokoyama, R. Hayashi, T. Kikkawa, N. Tani, S. Takada, K. Hatanaka and A. Yamamoto, Specific sorbent of apolipoprotein B-containing lipoproteins for plasmapheresis. Characterization and experimental use in hypercholesterolemic rabbits, Arteriosclerosis 4:276 (1984).PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1986

Authors and Affiliations

  • G. R. Thompson
    • 1
  • A. Jadhav
    • 1
  1. 1.MRC Lipoprotein TeamHammersmith HospitalLondonUK

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