免疫性神経疾患に対するアフェレシス(<特集>21世紀のアフェレシス-作用機序と臨床効果のエビデンス)

概要

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Therapeutic apheresis has been applied in neuroimmunological disorders, such as multiple sclerosis(MS), Guillain-Barre syndrome(GBS), chronic inflammatory demyelinating polyneuropathy(CIDP), and myasthenia gravis(MG). However, the mechanism of therapeutic apheresis has not been clarified yet, although the effectiveness of therapeutic apheresis has been well established in the neuroimmunological disorders. There are increasing evidences that plasmapheresis is involved not only in humoral immunity but also in cellular immune responses. Plasmapheresis clearly removes pathogenetic factors, such as autoantibody, inflammatory cytokines and/or chemical mediators, and complements. Furthermore, plasmapheresis may induce favorable suppressor immune responses, changing pattern of producing cytokines. Recently we and other investigators reported that plasmapheresis suppresses Th 1 immune responses and enhances Th 2 immune responses. These facts suggest that therapeutic plasmapheresis may affect not only humoral immune responses but also cellular immune responses, modulate immune responses, and thus induce favorable suppressor immune responses.
日本アフェレシス学会の論文
2001-02-28