russjcardiolРоссийский кардиологический журналRussian Journal of Cardiology1560-40712618-7620«SILICEA-POLIGRAF» LLC10.15829/1560-4071-2018-8-74-78russjcardiol-2838Research ArticleОБЗОРЫ ЛИТЕРАТУРЫREVIEWАФЕРЕЗ ЛИПОПРОТЕИДОВ: ВЧЕРА, СЕГОДНЯ, ЗАВТРАLIPOPROTEIN APHERESIS: YESTERDAY, TODAY, TOMORROW. REVIEWhttps://orcid.org/0000-0002-1584-5693JuliusU.JuliusU.

Профессор, доктор медицинских наук , зав. Центром Афереза Липопротеинов

TselminS.TselminS.

Кандидат медицинских наук, врач-интернист/научный сотрудник

Sergey.Tselmin@uniklinikum-dresden.dehttps://orcid.org/0000-0002-5211-2536BornsteinS. R.BornsteinS. R.

Профессор, доктор медицинских наук, директор медицинской клиники и поликлиники III

Stefan.Bornstein@unilklinikum-dresden.deКлиника им. Карла Густава Каруса при Техническом Университете ДрезденаГерманияUniversity Hospital Carl Gustav Carus at the Technische Universität DresdenGermany201809092018087478Copyright © Julius U., Tselmin S., Bornstein S.R., 20182018Julius U., Tselmin S., Bornstein S.R.Julius U., Tselmin S., Bornstein S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://russjcardiol.elpub.ru/jour/article/view/2838

Первые попытки лечения семейной гомозиготной гиперхолестеринемии (ГХ) плазмаферезом предпринимались в 60-70-е годы. Впоследствии, с появлением более специфичного метода — афереза липопротеинов (АЛ), отпала необходимость в замещении плазмы чужеродным белком. Была продемонстрирована решающая роль АЛ в продлении жизни этих больных, в то время как медикаментозная терапия показала в этих случаях значительно меньшую эффективность по сравнению с результатами её применения для лечения больных с другими типами ГХ. Тяжелые формы ГХ были признаны показаниями к применению АЛ у больных с сердечно-сосудистыми осложнениями. Повышенный уровень липопротеина(а) (Лп(а)) является международно признанным независимым атерогенным фактором риска. В связи с этим, экстракорпоральная терапия всё чаще проводится больным с повышенным Лп(а), страдающим такими тяжёлыми сердечно-сосудистыми осложнениями, как инфаркт миокарда или инсульт. В обзоре также обсуждается роль производимых в России колонок Лп(а) Липокак (ЗАО НПФ “ПОКАРД”, Россия) для специфического снижения липопротеина(а) в общем спектре методов АЛ. Ещё одним методом лечения станет в будущем антисмысловой олигонуклеотид для подавления синтеза аполипопротеина(а).

The first attempts to treat patients with homozygous familial hypercholesterolemia (HCH) were performed in the 60ies and 70ies using a total plasma exchange. Later on, more specific lipoprotein apheresis (LA) methods have been developed – the replacement with foreign proteins was no longer necessary. It could be demonstrated that LA is life-saving in these patients, lipid-lowering drugs were shown to be much less effective than in other HCH patients. A severe HCH became an accepted indication for LA when cardiovascular events appeared. An elevation of Lipoprotein(a) (Lp(a)) is an internationally accepted independent atherogenic risk factor. Thus, an increasing number of patients with high Lp(a) concentrations suffering from life-threatening cardiovascular events like a myocardial infarction or a stroke started to be treated extracorporeally. Russian specific PocardR anti-Lp(a) columns are produced, their position within the LA methods is discussed. In the future, an antisense oligonucleotide against apolipoprotein(a) will represent another therapeutic option.

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The authors declare that there are no conflicts of interest present.