動脈硬化治療におけるアフェレシスは有効か否か? : 動脈硬化治療の最近の知見(<特集>動脈硬化とアフェレシス)

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  • Is Apheresis Treatment for Atherosclerosis Effective or Not? : Overview of the Latest Treatment for Atherosclerosis

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Atherosclerosis, the underlying cause of cardiovascular disease (CVD), is characterized by lipid accumulation, lipoprotein oxidation, and inflammation. Atherosclerosis represents the major cause of premature death in modern societies. Recent therapies target risk factors, namely hypertension, hypercholesterolemia, hypertriglyceridemia and hyperglycemia. Extracorporeal elimination is a method of LDL-lowering therapy that is used in severe familial hypercholesterolemia (FH) after other therapeutic approaches have failed. LDL apheresis has been reported to be effective against steroid-resistant primary focal glomerulosclerosis, relapse of minimal-change nephrotic syndrome and diabetic nephropathy with nephrotic syndrome. In addition, LDL apheresis prevents the progression of atherosclerotic diseases including peripheral arterial occlusive disease (PAD). The favorable actions of LDL apheresis may include anti-inflammatory effects, suppression of oxidative stress, improvement of endothelial functions and alteration in the action of vasoactive compounds. In this article, we summarize the current view of the mechanisms of atherosclerosis, treatment of atherosclerosis and LDL apheresis treatment.

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