In
medicineMedicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
,
LDL apheresis is a form of
apheresisApheresis is a medical technology in which the blood of a donor or patient is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation...
, resembling
dialysisIn medicine, dialysis is primarily used to provide an artificial replacement for lost kidney function due to renal failure...
, to eliminate the
cholesterolCholesterol is a lipidic, waxy steroid found in the cell membranes and transported in the blood plasma of all animals. It is an essential component of mammalian cell membranes, where it is required to establish proper membrane permeability and fluidity...
-containing particle low-density lipoprotein (LDL) from the bloodstream.
It is used in diseases featuring high LDL, such as the
rareA rare disease, sometimes known as an orphan disease, is any disease that is not common. Typically, a rare disease has such a low prevalence in a population that a physician in a busy general practice would not expect to see more than one case a year....
homozygous familial hypercholesterolemiaFamilial hypercholesterolemia is a genetic disorder characterized by high cholesterol levels, specifically very high low-density lipoprotein levels, in the blood and early cardiovascular disease...
, when the
heterozygous form does not respond to medical treatment, or when the treatment has led to dangerous
side-effectsIn medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect, and may result from an unsuitable or incorrect dosage or...
(such as
rhabdomyolysisRhabdomyolysis is the rapid breakdown of skeletal muscle due to injury to muscle tissue. The muscle damage may be caused by physical , chemical, or biological factors...
).
The procedure takes 2-4 hours and must be repeated every several weeks to keep the LDL levels from accumulation and causing
cardiovascular diseaseCardiovascular disease or cardiovascular diseases is the class of diseases that involve the heart or blood vessels ....
.
It is an expensive procedure, limiting its use to severe cases of
hyperlipidemiaHyperlipidemia, hyperlipoproteinemia, dyslipidemia or hyperlipidaemia is the presence of raised or abnormal levels of lipids and/or lipoproteins in the blood...
.
LDL apheresis works by leading
venous bloodIn the circulatory system, venous blood is blood returning to the heart . With one exception this blood is deoxygenated and high in carbon dioxide, having released oxygen and absorbed CO
2 in the tissues...
through a column coated with
antibodiesAntibodies are gamma globulin proteins that are found in blood or other bodily fluids of vertebrates, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses...
to
apolipoprotein BApolipoprotein B is the primary apolipoprotein of low-density lipoproteins , which is responsible for carrying cholesterol to tissues. While it is unclear exactly what functional role APOB plays in LDL, it is the primary apolipoprotein component and is absolutely required for its formation...
(the main protein of LDL particles),
dextranDextran is a complex, branched glucan composed of chains of varying lengths...
sulfate or polyacrylate, or by precipitating LDL with
heparinHeparin, a highly-sulfated glycosaminoglycan, is widely used as an injectable anticoagulant, and has the highest negative charge density of any known biological molecule. It can also be used to form an inner anticoagulant surface on various experimental and medical devices such as test tubes and...
at low
pHpH is a measure of the acidity or basicity of a solution. It is defined as the cologarithm of the activity of dissolved hydrogen ions . Hydrogen ion activity coefficients cannot be measured experimentally, so they are based on theoretical calculations...
.
Discussion
Ask a question about 'LDL apheresis' Start a new discussion about 'LDL apheresis' Answer questions from other users |
In
medicineMedicine is the art and science of healing. It encompasses a range of health care practices evolved to maintain and restore health by the prevention and treatment of illness....
,
LDL apheresis is a form of
apheresisApheresis is a medical technology in which the blood of a donor or patient is passed through an apparatus that separates out one particular constituent and returns the remainder to the circulation...
, resembling
dialysisIn medicine, dialysis is primarily used to provide an artificial replacement for lost kidney function due to renal failure...
, to eliminate the
cholesterolCholesterol is a lipidic, waxy steroid found in the cell membranes and transported in the blood plasma of all animals. It is an essential component of mammalian cell membranes, where it is required to establish proper membrane permeability and fluidity...
-containing particle low-density lipoprotein (LDL) from the bloodstream.
Uses
It is used in diseases featuring high LDL, such as the
rareA rare disease, sometimes known as an orphan disease, is any disease that is not common. Typically, a rare disease has such a low prevalence in a population that a physician in a busy general practice would not expect to see more than one case a year....
homozygous familial hypercholesterolemiaFamilial hypercholesterolemia is a genetic disorder characterized by high cholesterol levels, specifically very high low-density lipoprotein levels, in the blood and early cardiovascular disease...
, when the
heterozygous form does not respond to medical treatment, or when the treatment has led to dangerous
side-effectsIn medicine, an adverse effect is a harmful and undesired effect resulting from a medication or other intervention such as surgery. An adverse effect may be termed a "side effect", when judged to be secondary to a main or therapeutic effect, and may result from an unsuitable or incorrect dosage or...
(such as
rhabdomyolysisRhabdomyolysis is the rapid breakdown of skeletal muscle due to injury to muscle tissue. The muscle damage may be caused by physical , chemical, or biological factors...
).
The procedure takes 2-4 hours and must be repeated every several weeks to keep the LDL levels from accumulation and causing
cardiovascular diseaseCardiovascular disease or cardiovascular diseases is the class of diseases that involve the heart or blood vessels ....
.
It is an expensive procedure, limiting its use to severe cases of
hyperlipidemiaHyperlipidemia, hyperlipoproteinemia, dyslipidemia or hyperlipidaemia is the presence of raised or abnormal levels of lipids and/or lipoproteins in the blood...
.
Principles
LDL apheresis works by leading
venous bloodIn the circulatory system, venous blood is blood returning to the heart . With one exception this blood is deoxygenated and high in carbon dioxide, having released oxygen and absorbed CO
2 in the tissues...
through a column coated with
antibodiesAntibodies are gamma globulin proteins that are found in blood or other bodily fluids of vertebrates, and are used by the immune system to identify and neutralize foreign objects, such as bacteria and viruses...
to
apolipoprotein BApolipoprotein B is the primary apolipoprotein of low-density lipoproteins , which is responsible for carrying cholesterol to tissues. While it is unclear exactly what functional role APOB plays in LDL, it is the primary apolipoprotein component and is absolutely required for its formation...
(the main protein of LDL particles),
dextranDextran is a complex, branched glucan composed of chains of varying lengths...
sulfate or polyacrylate, or by precipitating LDL with
heparinHeparin, a highly-sulfated glycosaminoglycan, is widely used as an injectable anticoagulant, and has the highest negative charge density of any known biological molecule. It can also be used to form an inner anticoagulant surface on various experimental and medical devices such as test tubes and...
at low
pHpH is a measure of the acidity or basicity of a solution. It is defined as the cologarithm of the activity of dissolved hydrogen ions . Hydrogen ion activity coefficients cannot be measured experimentally, so they are based on theoretical calculations...
. In all cases (apart from polyacrylate absorption),
plasmaBlood plasma is the yellow liquid component of blood, in which the blood cells in whole blood would normally be suspended. It makes up about 55% of the total blood volume. It is mostly water and contains dissolved proteins, glucose, clotting factors, mineral ions, hormones and carbon dioxide...
is separated from
cellsA blood cell is any cell of any type normally found in blood. In mammals, these fall into three general categories:* red blood cells — Erythrocytes* white blood cells — Leukocytes...
by a cell separator.
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