Removal of Cholesterol from Blood by Affinity Binding to Heparin-Agarose: Evaluation on Treatment in Homozygous Familial Hypercholesterolemia

Abstract

Summary: Extracorporeal removal of cholesterol from blood with heparin-agarose conjugates was studied as a means of reducing the plasma cholesterol concentration in two patients with homozygous familial-hypercholesterolemia. Both patients were treated in an outpatient clinic. Patient 1 underwent two separate courses of treatment; during the first course of eight treatments, the plasma cholesterol concentration decreased by a maximum of 54% (from 811–370 mg/dl). The six treatments in the second course resulted in a 35% reduction of plasma cholesterol (from 939–632 mg/dl). In patient two, 12 consecutive treatments resulted in a 56% decrease in the concentration of plasma cholesterol (from 768–298 mg/dl). Repetitive treatments in both patients resulted in a new “steady state” with circulating cholesterol levels lower than the pretreatment baseline value. The decrease in plasma cholesterol is mainly due to the removal of low density lipoproteins. The circulating level of high density lipoproteins is unaffected by the treatment. The treatment has no effect on the chemical composition of both low and high density lipoproteins. The extracorporeal treatment of blood with heparin-agarose was well tolerated by both patients and there were no undesirable effects. The effectiveness and simplicity of the present approach makes it attractive as a possible mode of therapy for homozygous familial hypercholesterolemia.

Speculation: Reduction of plasma cholesterol by the removal of low density lipoproteins in an extracorporeal system is described as a possible mode of therapy for homozygous familial hypercholesterolemia. The effective control of plasma low density lipoprotein level in these patients on long term basis, may permit to evaluate its effect on tissue deposits of cholesterol and atherosclerotic disease.

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