ネフローゼ症候群におけるアフェレシス療法(<特集>腎・血液領域の注目すべき疾患-アフェレシス療法のエビデンスとガイドライン-)

概要

論文の詳細を見る
Accumulating evidence has shown that apheresis may have a beneficial effect, at least in part, on the treatment of patients with steroid-resistant nephrotic syndrome. A considerable permeability factor(s) derived from circulating T cells or B cells is likely to have a role in the pathogenesis of steroid-resistant nephrotic syndrome. Lymphocytapheresis might be a strong tool to remove these mediators from activated lymphocytes and/or the lymphocytes themselves. In addition, circulating factors including immune-complexes and low-density lipoprotein contribute to the pathogenesis of nephrotic syndrome. To remove these circulating factors, plasma exchange, immunoadsorption using protein A sepharose cartridges, and low-density lipoprotein apheresis could be widely used. In this review, we summarize clinical impacts of apheresis especially on steroid-resistant nephrotic syndrome. Even though apheresis might have additional effects to those of immunosuppression therapy, the recommendations based on evidence remain at a low level. Larger randomized controlled trials of apheresis for the treatment of nephrotic syndrome are required.
日本アフェレシス学会の論文
2006-02-28