慢性関節リウマチの白血球除去療法 : エジプト綿を使用して

概要

論文の詳細を見る
This paper discusses the short-term effects of filter leukapheresis for RA patients. Its feasibility for clinical use and the mechanism are also discussed. Imugards (Terumo Co., Ltd., Japan) were used as the leukocyte removal filter. The schedule of treatment was once weekly for 3 weeks, then twice monthly for 2 months. Heparin was used and 1,400 ml of whole blood was processed at a blood flow rate of 30 ml/min. The laboratory tests performed were CBC, C_3, C_4, IgG, IgA. IgM and lymphocyte subsets. Nineteen intractable RA patients were treated, 17 females and 2 males : stage II, 4 ; III, 6 and IV, 9. The ACR core set was used for clinical assessment, and more than 20% reduction as compared to value before treatment was regarded as improvement. Fourteen out of 19 showed improvement. Five patients failed to respond without deterioration, and they were all stage IV. No severe side effects were observed. Clinical improvements were seen in all parameters, whereas ESR and RF increased and anemia progressed. A decrease occurred in the percentage of CD 11 b+CD8 + cells and increases in that of CD 4 + HLA- DR - /CD 45 RA + and CD 11 B-CD + cells. This treatment proved feasible, and the mechanism is speculated to be that immunomodulation occurs when the blood contacts the filter.
日本アフェレシス学会の論文
1998-10-31