Effect of Double Filtration Plasmapheresis (DFPP) in Male Patients with Borderline Hyper-LDL-cholesterolemia : Lipid Removal and Inflammation Suppression

Objective: Double filtration plasmapheresis (DFPP) removal of LDL cholesterol (LDL-C) and other pathogenic substances in the blood has attracted attention as an effective treatment of arteriosclerotic lesions. We conducted a controlled open-label study to understand the physical and mental effects of DFPP.Methods: Seven (7) male patients with borderline hyper-LDL-C (134.0±41.1 mg/dL) were assigned to a DFPP group (age 43.0±5.3 years, BMI 26.0±4.5) and 7 others were assigned to a control group (age 39.1±11.4 years, BMI 28.9±8.1). The observation period was 8 weeks. Patients in the DFPP group received DFPP twice. The evaluation included the Anti-Aging QOL Common Questionnaire (AAQol) and the blood vessel tests of Pulse wave velocity (PWV) and ankle-brachial index (ABI).Results: Among physical symptoms in AAQol, “tired eyes,” “blurry eyes,” “stiff shoulders,” and “feeling of ill-health” significantly decreased after 8 weeks in the DFPP group. Hematology revealed that hemoglobin (+3.6%, p=0.047), total protein (+4.1%, p=0.019), and albumin (+4.9%, p=0.018) were maintained at higher levels after 8 weeks in the DFPP group than the control group. Despite LDL-C removal, the hepatic steatosis index ALT (+5.7%, p=0.008) and lipid metabolism index LDL-C (+11.6%, p=0.012) were apparently higher in the DFPP group. Endocrinology showed a decreasing trend of DHEA-s (−13.7%, p=0.003), increasing trend of cortisol (+27.5%, p=0.005), and increasing trend of progesterone (+50%, p=0.030) in the DFPP group compared with the control group. High-sensitivity CRP tended to decrease in the DFPP group compared with the control group (−26.5%, p=0.030). There was no significant change in PWV or ABI in the DFPP group. No serious adverse events were caused by DFPP.Conclusion: LDL-C removal by DFPP might suppress inflammation and improve tissue environment in visceral adipose and liver tissues with fatty deposits.