The Impact of Lipoprotein Apheresis on Inflammatory Factors: A Systematic Review and Meta-Analysis


Hatami A., Eslami M., Aslani S., Alizadeh S., Sukhorukov V. N., KARAV S., ...More

Journal of Clinical Apheresis, vol.40, no.6, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Publication Type: Article / Article
  • Volume: 40 Issue: 6
  • Publication Date: 2025
  • Doi Number: 10.1002/jca.70082
  • Journal Name: Journal of Clinical Apheresis
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE
  • Keywords: apheresis, C-reactive protein, hs-CRP, IL-6, inflammation, meta-analysis, systematic review, TNF-α
  • Çanakkale Onsekiz Mart University Affiliated: Yes

Abstract

Lipoprotein apheresis is a well-established therapy for patients with dyslipidemia unresponsive to conventional lipid-lowering strategies. However, its impact on systemic inflammation remains uncertain. This systematic review and meta-analysis evaluated the effect of apheresis on circulating inflammatory markers, including C-reactive protein (CRP), high-sensitivity CRP (hs-CRP), interleukin-6 (IL-6), and tumor necrosis factor-alpha (TNF-α). Following PRISMA guidelines, a systematic search of PubMed, Scopus, and ISI Web of Science was conducted up to June 2025. Studies reporting pre- and post-apheresis values for inflammatory markers were included. Standardized mean differences (SMD) and 95% confidence intervals (CI) were calculated. Thirteen publications met inclusion criteria. Meta-analysis demonstrated that apheresis significantly reduced CRP levels (SMD = −0.31; 95% CI: −0.44 to −0.18; p < 0.001), particularly in long-term interventions. No significant changes were observed for IL-6, TNF-α, or hs-CRP. In conclusion, apheresis significantly reduces CRP levels, especially with long-term treatment, suggesting a modest anti-inflammatory benefit. However, its effects on other markers remain unclear. Larger and high-quality trials are warranted.