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Three patients with heterozygote type IIa hyperlipoproteinemia were treated by specific LDL apheresis with a dextran sulfate-cellulose column every two weeks. Each apheresis resulted in a fall in total cholesterolemia of about 50 p. 100 with a parallel fall in apoprotein B. The average drop of 15 p. 100 in HDL-cholesterol appeared to be due to the hemodilution induced at the end of apheresis. After two months, cholesterol and apoprotein B concentrations before removal were 15 p. 100 lower than baseline values. Treatment was well tolerated. These findings appear encouraging for the treatment of heterozygote forms of familial hyperlipoproteinemia resistant to chemotherapy.

The study of the coagulation in rats fed with a balanced diet, including 12% of different animal or vegetable fats, during 6 months, shows that the time of coagulation in rats receiving one of the following oils: palm, sunflower, Canbra, is significantly higher than the ones fed with butter. On the other hand, the coagulation time observed in the groups is correlated with the oleic acid level in the corresponding diet. The results obtained here may lead to important practical applications.

The intake of a stable diet during 25 months by 68 women living in a closed religious community allowed us to study the effects of various alimentary fats on the serum lipids. Thus we could observe the consequences of the quantitatively and qualitatively different fatty acids in the diet, while the total quantity of lipids and the other constituents of the dietary intake were unaltered. The serum total cholesterol and apoprotein B levels are correlated with the P/S ratio of the diet; on the contrary, the serum HDL cholesterol and apoprotein A levels are not correlated with the fatty acid composition of the diet. The moderate supply in lipids (30% of the total caloric intake) and cholesterol (300 mg/day) maintained during this study corresponds to the usual dietary recommendations. Therefore, not very high levels of serum total cholesterol were observed, whichever vegetable oil was consumed.

The effects of 3 dietary fats (olive oil, canbra oil and butter) on the fatty acids of blood lipids and on serum lipoproteins were compared in 6 healthy adult outpatients, after a 6-day normocaloric diet including 35% of the studied fat. Important, although incomplete, changes appeared in the fatty acid composition of the various serum lipids and in the composition and distribution of serum lipoproteins. These changes probably result from the degree of saturation of the fat ingested. Moreover, differences were observed among individual subjects. Genetic differences, which are important in clinical practice, are stressed in connection with risks of vascular diseases and hyperlipidemia and affect intestinal fat absorption and lipoprotein metabolism.

The effect of treatment with simvastatin, a new HMG-CoA reductase inhibitor, has been investigated in 27 patients with primary hypercholesterolaemia. It produced a significant decrease of cholesterol and phospholipids in plasma, LDL and apolipoprotein B-containing lipoproteins. Plasma apolipoproteins B, C-III and E were also significantly lowered. The concentration of lipoprotein particles recognized by monoclonal antibodies (BL3, BL5 and BL7), associated with atherosclerotic disease, was also lowered by the treatment. Lipoproteins LpA-II:A-I were not changed, while LpA-I, which has been suggested to be the protective fraction of the apo A-I-containing lipoproteins, was slightly and inconsistently increased.

The [3H]cholesterol efflux from cultured skin fibroblasts was investigated in 12 patients, clinically heterozygous for familial hypercholesterolemia (FH). The [3H]cholesterol efflux from fibroblasts was studied in the presence of high-density lipoproteins, isolated either from control sera or from the patient's own serum. The [3H]cholesterol efflux from fibroblasts of 3 patients was increased; it was decreased for 4 patients and similar to that of control cells for 5 patients. This study indicates that in some patients with heterozygous FH, abnormalities of [3H]cholesterol efflux from fibroblasts can be detected. The heterogeneity of the results is consistent with the heterogeneity of the low-density lipoprotein receptor activity and with the variability of the clinical picture found in this disease.