潰瘍性大腸炎に対するLeukocytapheresis(LCAP)の新たな試み(<特集>炎症性腸疾患に対するアフェレシスの新展開)

概要

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Backgrounds: We evaluated clinical effects of leukocytapheresis (LCAP) with 1.5L blood processing (1.5L-LCAP) in patients with active ulcerative colitis (UC). Furthermore, we analyzed the efficacy of 5 consecutive 1.5L-LCAPs. Methods: Ten patients with moderate to severe UC were enrolled in the analyses of 1.5L-LCAP effects. Six patients were enrolled in analyses of 5 consecutive 1.5L-LCAP treatment. Clinical and endoscopic effects were assessed using the clinical activity index (CAI) described by Rachmilewitz and Matts' endoscopic classification, respectively. Results: The 1.5L-LCAP induced clinical remission in 8 of 10 patients (80%). Endoscopic improvement was noted in 6 of 7 patients (85.7%). Adverse effects were not observed. The IL-1β-induced IL-8 and IL-6 secretion in peripheral blood mononuclear cells were significantly reduced by 1.5L-LCAP therapy. Under 5 consecutive 1.5L-LCAP therapy, two patients went into remission with an improvement in the endoscopic appearance after one week. However, in 4 patients there were no improvement. The platelet count by the 5th session reached half of the initial value before the first session. Conclusions: 1.5L-LCAP was clinically effective for active UC patients. Cellular responses by 1.5L-LCAP were similar to those induced by standard LCAP session. The 5 consecutive LCAPs are also safe and feasible for active UC patients.
2011-02-28