拡張型心筋症に対する免疫吸着療法の安全面からのプロトコールの検討(<特集>心疾患とアフェレシス)

概要

論文の詳細を見る
Ten Japanese patients with dilated cardiomyopathy (DCM) were treated with immunoadsorption (IA) therapy using tryptophan columns (Immusorba TR^[○!R], Asahi Kasei Kuraray Medical). We tested the efficacy and safety of IA therapy for DCM patients. Patients received five IA sessions. At each session of therapy, 2,000mL of plasma was perfused over the column. In case 4, the left ventricular ejection fraction increased after IA therapy from 10.6% to 24%, and BNP decreased from 608.9pg/dL to 93.1pg/dL. No adverse effect on circulation was seen during the IA sessions in any of the ten patients. Immunoglobulin decreased after five sessions of IA therapy (before IA 1,237±343mg/dL; after five IAs 550±353mg/dL), and fibrinogen decreased (before IA 358±103mg/dL; after five IAs 85±30mg/dL). However, no infection was observed. After perfusion of 1,500ml of serum, the removal rate of IgG subclass 3 was 51%, and after perfusion of 2,000ml of serum, the removal rate of IgG subclass 3 was 26%. This study demonstrated the safety and efficacy of IA for DCM patients with advanced HF. Further investigation and longer-term follow-up are needed to confirm the effects on cardiac function and morbidity/mortality in severe DCM patients who are treated by IA therapy.
2010-05-31