Low density lipoprotein apheresis ameliorates interferon-γ production in patients with nephrotic syndrome

Ther Apher Dial. 2012 Apr;16(2):189-94. doi: 10.1111/j.1744-9987.2011.01045.x. Epub 2012 Feb 27.


Rapid amelioration of hypercholesterolemia in nephrotic syndrome (NS) using low density lipoprotein-apheresis (LDL-A) sometimes leads to NS remission, along with improvement of impaired biodefense system; however, the mechanism of how LDL-A affects NS is still unknown. We studied IFN-γ production under IL-12 stimulation for 24 h in whole blood from 30 NS patients, 31 non-NS patients, 35 healthy volunteers and another four persistent NS patients due to refractory focal segmental glomerulonephritis and minimal change type nephrotic syndrome. We compared IFN-γ production in whole blood and peripheral blood mononuclear cells (PBMC) from persistent NS patients before and after each of 14 LDL-A procedures. Finally, we studied the effect that persistent NS patients' serum before and after LDL-A had on IFN-γ production in healthy volunteers' PBMC. Whole blood IFN-γ production was significantly lower in NS patients compared with healthy volunteers or non-NS patients. In persistent NS, after LDL-A, IFN-γ production returned to normal levels. IFN-γ production in PBMC varied greatly among these patients and did not show consistent changes after LDL-A. Healthy volunteers PBMC incubated with persistent NS patients' serum obtained after LDLA showed higher IFN-γ production than before LDL-A. IFN-γ production in peripheral blood is impaired if a patient is in a nephrotic state. LDL-A might restore suppressed PBMC function in persistent NS patients, thereby ameliorating the nephrotic state, possibly through removing interfering serum factors.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Blood Component Removal / methods*
  • Female
  • Humans
  • Hypercholesterolemia / therapy*
  • Interferon-gamma / blood*
  • Leukocytes, Mononuclear / metabolism*
  • Lipoproteins, LDL / blood*
  • Male
  • Nephrotic Syndrome / blood*
  • Nephrotic Syndrome / therapy


  • Lipoproteins, LDL
  • Interferon-gamma