Horm Metab Res 2022; 54(04): 238-249
DOI: 10.1055/a-1776-7943
Original Article: Endocrine Care

Precision Medicine Approach for Cardiometabolic Risk Factors in Therapeutic Apheresis

X. Yin
1   Kings College London, London, UK
K. Takov
1   Kings College London, London, UK
R. Straube
2   Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
K. Voit-Bak
2   Zentrum für Apherese- und Hämofiltration am INUS Tagesklinikum, Cham, Germany
J. Graessler
3   Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
U. Julius
3   Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
S. Tselmin
3   Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
Roman N. Rodionov
3   Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
M. Barbir
4   Royal Brompton Hospital, London, UK
M. Walls
5   GENinCode, Oxford, UK
K. Theofilatos
1   Kings College London, London, UK
M. Mayr
1   Kings College London, London, UK
6   Technische Universität Dresden, Dresden, Germany
S.R. Bornstein
1   Kings College London, London, UK
3   Department and Outpatient Department of Medicine III, University Hospital Carl Gustav Carus, Dresden, Germany
› Author Affiliations
Funding Information M.M. is a British Heart Foundation (BHF) Chair Holder (CH/16/3/32406) with BHF program grant support (RG/16/14/32397). The research was also supported by the National Institute for Health Research (NIHR) Biomedical Research Centre based at Guy’s and St Thomas’ NHS Foundation Trust and King’s College London (the views expressed are those of the author(s) and not necessarily those of the NHS, the NIHR or the Department of Health). M.M. is also supported by the Leducq Foundation (18CVD02) and the VASCage – Research Center on Vascular Ageing and Stroke (No. 868624). transCampus is funded by the Federal Ministry of Education and Research (BMBF) and the Freestate of Saxony under the Excellence Strategy of the Federal Government and the Länder.


Lipoprotein apheresis (LA) is currently the most powerful intervention possible to reach a maximal reduction of lipids in patients with familial hypercholesterolemia and lipoprotein(a) hyperlipidemia. Although LA is an invasive method, it has few side effects and the best results in preventing further major cardiovascular events. It has been suggested that the highly significant reduction of cardiovascular complications in patients with severe lipid disorders achieved by LA is mediated not only by the potent reduction of lipid levels but also by the removal of other proinflammatory and proatherogenic factors. Here we performed a comprehensive proteomic analysis of patients on LA treatment using intra-individually a set of differently sized apheresis filters with the INUSpheresis system. This study revealed that proteomic analysis correlates well with routine clinical chemistry in these patients. The method is eminently suited to discover new biomarkers and risk factors for cardiovascular disease in these patients. Different filters achieve reduction and removal of proatherogenic proteins in different quantities. This includes not only apolipoproteins, C-reactive protein, fibrinogen, and plasminogen but also proteins like complement factor B (CFAB), protein AMBP, afamin, and the low affinity immunoglobulin gamma Fc region receptor III-A (FcγRIIIa) among others that have been described as atherosclerosis and metabolic vascular diseases promoting factors. We therefore conclude that future trials should be designed to develop an individualized therapy approach for patients on LA based on their metabolic and vascular risk profile. Furthermore, the power of such cascade filter treatment protocols may improve the prevention of cardiometabolic disease and its complications.

Supplementary Material

Publication History

Received: 15 January 2022

Accepted after revision: 15 February 2022

Article published online:
12 April 2022

© 2022. Thieme. All rights reserved.

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