壊疽性膿皮症に対する白血球除去療法(<特集>血球成分除去療法の新しい展開)

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Pyoderma gangrenosum, clinically characterized by sterile skin ulcerations, shows histologically a dense neutrophil infiltration in the dermis and/or subcutaneous tissue. Although systemic glucocorticoids, immunosuppressive agents, and anti-tumor necrosis factor-α agents are often effective for pyoderma gangrenosum, there are some refractory cases. Leukocytapheresis, designed to remove the pathogenic neutrophils, have recently shown remarkable effects on ulcerative colitis and also on pyoderma gangrenosum. There are three types of leukocytapheresis: 1) adsorption method (granulocyte and monocyte adsorption apheresis), 2) filtration method and 3) centrifugation method. The efficacy of leukocytapheresis on pyoderma gangrenosum has been recognized in 24 cases since the first report in 2002. No adverse effects have been observed in any patients. Thus, I propose leukocytapheresis as a useful treatment modality for pyoderma gangrenosum, but there still remain some problems to be solved. A clinical double-blind study to show the effectiveness of leukocytapheresis in pyoderma gangrenosum and also a basic study to elucidate the precise mechanisms of these therapies are required. In our study, leukocytapheresis (granulocyte and monocyte adsorption apheresis) was effective for severe pain of pyoderma gangrenosum, but the effectiveness of this therapy should be determined in various clinical types of pyoderma gangrenosum.
日本アフェレシス学会の論文
2009-02-28

壊疽性膿皮症に対する白血球除去療法(<特集>血球成分除去療法の新しい展開)

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