炎症性腸疾患に対する顆粒球・単球除去療法 : 有用性とそのメカニズム(<特集>血球成分除去療法の新しい展開)

概要

論文の詳細を見る
Several uncontrolled studies have reported on the efficacy of GMA in patients with steroid dependent or steroid refractory IBD being associated with striking efficacy and tapering or discontinuation of steroids. Further based on our experience, GMA seems to have an excellent safety profile. Granulocytes and monocytes are major sources of inflammatory cytokines and therefore, it is assumed that high and activated circulating levels of these leukocytes can be a major pro-inflammatory condition. GMA was associated with improvements of clinical symptoms and marked reductions in the level of various inflammatory cytokines which are produced by granulocytes and monocytes. TNF-α is a major factor in the pathogenesis of IBD and clinical efficacy of anti-bodies to TNF-α has been reported in patients with CD and UC. We found high levels of soluble-TNF-α RI/RII (receptor) in the serum of patients with UC. Soluble-TNF-α RI/RII showed strong correlation with clinical disease activity. The major sources of soluble-TNF-α RI/RII are believed to be activated monocytes and neutrophils with further release when these leukocytes adhere to the cellulose acetate carriers of the column. A significant reduction in peripheral CD 14^+ CD 16^+ monocytes by GMA should mitigate the inflammatory drive and contribute to the clinical efficacy of this procedure. Thus GMA is an immunomodulate and natural biological therapy for IBD.
日本アフェレシス学会の論文
2009-02-28