Recombinant Human Autoantigens as an Extracorporeal Immunoadsorbent in Therapeutic Apheresis(Symposium 1: Immunoadsorption versus Intravenous Immunoglobulin for Autoimmune Diseases)

概要

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Effective control of the systemic vasculitides often requires high-dose immunosuppression, and relapse of disease is common even in those patients in whom a prolonged course of treatment is used. The presence of antineutrophil cytoplasmic antibodies (ANCA) with specificity for proteinase 3 (PR3) and myeloperoxidase (MPO) is characteristic of these conditions and is believed to be pathogenetically important. Removal of these humoral mediators of endothelial cell damage is a desirable therapeutic goal. We have demonstrated the importance of charge interactions in the binding of ANCA to their target antigens and the depletion of serum ANCA activity by cationic, but not anionic exchange resins. The in vivo extension of this observation has been the effective and clinically useful removal of ANCA by tryptophan immunoadsorption (IA). The availability of recombinant MPO has led to the development of a strategy for specific IA and the first patient has been treated with this novel therapeutic option.
日本アフェレシス学会の論文