Background
Double Filtration Plasma Exchange (DFPP) is a selective apheresis technique designed to remove pathogenic plasma components. This study investigates the molecular determinants linking DFPP waste composition with changes in brachial-ankle pulse wave velocity (baPWV), a clinical indicator of arterial stiffness.
Methods
High-throughput metabolomic and LC-MS/MS-based proteomic analyses were performed on DFPP waste samples. baPWV was measured before and after treatment. Differential metabolites and proteins were identified between high and low ΔPWV groups. Pathway enrichment analysis was performed, and associations with ΔPWV were assessed using linear regression models adjusted for age, sex, and BMI.
Results
DFPP significantly reduced baPWV in most patients. Proteomic profiling identified 2,017 plasma proteins, among which 38 were significantly associated with ΔPWV. These proteins were enriched in pathways related to inflammation, coagulation, lipid metabolism, and mitochondrial function. Metabolomic profiling revealed 16 ΔPWV-associated metabolites—mainly ceramides and phosphatidylcholines—implicating lipid remodeling and oxidative stress. Multivariate models confirmed these associations after adjustment for confounders.
Conclusion
DFPP modulates circulating proteins and metabolites in ways that may alleviate arterial stiffness. Key molecules—such as CA2, THBS1, Cer(d18:0/16:0), and PC 38:4—highlight potential mechanisms of vascular rejuvenation and may serve as candidate biomarkers or therapeutic targets. This integrative omics analysis provides new insight into the vascular effects of DFPP.
Keywords: DFPP, pulse wave velocity, proteomics, metabolomics, arterial stiffness
*Corresponding Author Email address: xhchen66@126.com
 

DFPP, pulse wave velocity, proteomics, metabolomics, arterial stiffness