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(Arteriosclerosis, Thrombosis, and Vascular Biology. 2004;24:1111.)
© 2004 American Heart Association, Inc.

Atherosclerosis and Lipoproteins

Ascorbate Supplement Reduces Oxidative Stress in Dyslipidemic Patients Undergoing Apheresis

Chiang-Ting Chien; Wei-Tien Chang; Heui-Wen Chen; Tzung-Dau Wang; Shaw-Yih Liou; Tzay-Jinn Chen; Yen-Lin Chang; Yuan-Teh Lee; Su-Ming Hsu

From Departments of Medical Research (C.T.-C, H.-W.C.,), Internal Medicine (W.-T.C., T.-D.W., Y.-T.L.), and Pathology (S.-M.H.), National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei; Formosan Blood Purification Foundation (S.-Y.L.), Taipei; Department of Health (T.-J.C.), Taichung; Department of Biomedical Engineering (Y.-L.C.), Chung-Yuan Christian University, ChungLi, Taiwan.

Correspondence to Dr Su-Ming Hsu, Department of Pathology, National Taiwan University Hospital, 7 Chung-Shun S Road, Taipei, Taiwan. E-mail smhsu{at}ha.mc.ntu.edu.tw or Dr Yuan-Teh Lee, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shun S Road, Taipei, Taiwan. E-mail ytlee@ha.mc.ntu.edu.tw

Objective— The effect of ascorbate treatment on apheresis-induced oxidative stress in uremic and dyslipidemic patients was evaluated.

Methods and Results— We developed a chemiluminescence-emission spectrum and high-performance liquid chromatography analysis to assess the effect of ascorbate supplement on plasma reactive oxygen species (ROS) scavenging activity and oxidized lipid/protein production in hyperlipidemic and uremic patients undergoing apheresis. Apheresis was efficient in reduction of atherogenic lipoproteins, complement, fibrinogen, soluble intercellular adhesion molecule-1, and oxidative parameters including phosphatidylcholine hydroperoxide (PCOOH), malonaldehyde, methylguanidine, and diotyrosine. Apheresis itself, however, activated leukocytes to increase ROS activity and reduced the plasma ROS scavenging activity. Ascorbate administration selectively diminished apheresis-enhanced H₂O₂ and inflammatory mediators such as tumor necrosis factor alpha (TNF-) and monocyte chemoattractant protein-1. Chronically dyslipidemic and uremic patients undergoing biweekly apheresis plus ascorbate treatment had lower levels of C-reactive protein and PCOOH than did those without ascorbate treatment during a 6-month follow-up study period.

Conclusions— We demonstrate that apheresis with ascorbate treatment provides a therapeutic potential in reducing atherosclerotic risk via inhibition of H₂O₂-induced oxidative stress in patients with uremia or dyslipidemia.

Apheresis with ascorbate treatment provides a therapeutic potential in reducing atherosclerotic risk via inhibition of H₂O₂-induced oxidative stress in dyslipidemic patients with uremia or hyperlipidemia.

Key Words: apheresis • reactive oxygen species • atherosclerosis • dialysis • vitamin C

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