There are numerous pro- and anti-inflammatory factors involved in the pathophysiology of human atherosclerosis. LDL apheresis affects many of these factors including the complement cascade, the cytokine network and several other inflammatory mediators. Several studies demonstrate an apparently beneficiary profile regarding these factors during LDL apheresis, most likely due to adsorption of the mediators to the columns. This could potentially be of benefit for these patients with respect to progression Metformin mouse of arteriosclerosis,

in addition to lowering their LDL cholesterol. However, most of the studies cited are small, have utilized different kinds of apheresis columns, have studied different patients groups and, most importantly, have a limited and partly diverse panel of mediators included. Although a net effect in certain apheresis systems might be anti-inflammatory, as evaluated by plasma measurements, a main goal for future improvement of apheresis columns will be to make them as biocompatible as possible, that is, being inert with respect to complement, cytokines and the remaining inflammatory network. There are definitely

more mediators generated by the artificial surface than we are measuring and, thus, proinflammatory mediators may contribute more than apparent from current studies. Therefore, to get more insight into the effects on inflammation induced by LDL apheresis, check details larger studies should be performed, preferably comparing the effect of different LDL apheresis columns on the total inflammatory profile, by

including a broad spectrum of biomarkers. Furthermore, changes in pro- and anti-inflammatory biomarkers should ideally be correlated to clinical endpoints. Considering the fact that each centre performing LDL apheresis has D-malate dehydrogenase a relatively limited number of patients, multicentre trials would be required. Although the total number of patients available for clinical studies probably would preclude the use of hard endpoints like death or myocardial infarction, surrogate endpoints like carotid intimae media thickness or coronary calcium score evaluated by computerized tomography would undoubtedly add valuable information about the relationship between inflammatory biomarkers and the process of atherosclerosis. “
“Sepsis is characterized by a severe systemic inflammatory response to infection that is associated with high morbidity and mortality despite optimal care. Invariant natural killer T (iNK T) cells are potent regulatory lymphocytes that can produce pro- and/or anti-inflammatory cytokines, thus shaping the course and nature of immune responses; however, little is known about their role in sepsis. We demonstrate here that patients with sepsis/severe sepsis have significantly elevated proportions of iNK T cells in their peripheral blood (as a percentage of their circulating T cells) compared to non-septic patients.