ループス腎炎治療における血漿交換療法の有用性(<特集>膠原病とアフェレシス)

概要

論文の詳細を見る
Plasma exchange(PE)has been used for over 2 decade to treat lupus nephritis. Clinical studies are utilized to evaluate its efficacy. In contrast to these studies consisting of short-term intensive therapy, we suggest a possible role for prolonged plasma exchange therapy of lupus nephritis. A trend toward better preservation of renal function and proteinuria was identified in the PE treatment. The clinical results of treating patients with renal damage support a role for plasma exchange in the selective treatment of rapidly progressive diffuse proliferative lupus nephritis. The studies support a role for PE in the routine treatment of lupus nephritis. Infusion of normal plasma may itself have beneficial effects, independent of the removal of abnormal circulating factors. Indeed, there is compelling evidence that replacement of a deficient plasma component contributes to, and may be the principal mechanism of action of PE in lupus nephritis. These include the depletion of complement products, fibrinorgen and possibly cytokines, improve- ment in reticuloendothelial system function and immunomodulatory actions such as alterations in antibody balance. The influence of PE on cellular immune mechanisms, if any is poorly defined.
日本アフェレシス学会の論文
1997-05-31