Lipid apheresis (extracorporeal
lipoprotein elimination) is administered to patients with
familial hypercholesterolemia who fail to respond to standard
therapy. The nature of the treatment process raises the suspicion that it decreases not only
cholesterol but also
antioxidants. A group of 12 patients (average age 47±17 y, 4 homozygous and 8 heterozygous individuals) with
familial hypercholesterolemia treated by
LDL-
apheresis or rheohaemapheresis for 3-12 y was included in the study. In addition to
cholesterol and
triacylglycerol levels,
vitamin E and
vitamin A and also other markers of
antioxidant activity were investigated. Nevertheless, the most important determined parameter was the
vitamin E/
cholesterol ratio in serum and
lipoproteins. The results indicate that both extracorporeal elimination methods are effective and suitable ways to treat severe
familial hypercholesterolemia, as the
LDL fraction of
cholesterol decreased by approximately 77% and 66% following
LDL-
apheresis and rheohaemapheresis, respectively. In addition, the serum
vitamin E decreased by 54% and 57% and the decrease of the serum
vitamin A was approximately 20%. However, the main marker of
antioxidant capacity,
vitamin E/
cholesterol ratio, in the serum, VLDL and
LDL significantly increased. The increase of
vitamin E levels in the erythrocyte membranes of 2% following
LDL-
apheresis and a significant increase of 4% following rheohaemapheresis were confirmed. The presented results indicate that
LDL-
apheresis and rheohaemapheresis can be considered to be safe procedures according to the
antioxidant capacity of the serum, VLDL and
LDL lipoprotein fractions and the erythrocyte membrane.