title: Selective removal of anti-acetylcholine receptor antibody in the low temperature operation of membrane plasma fractionation.
abstract: The removal of anti-acetylcholine receptor antibody (anti-AChR Ab) by the plasma fractionator, Kuraray EVAL 2A, was measured as a function of the filtration temperature (4 and 37 degrees C). Plasmas procured from eight myasthenia gravis (MG) patients undergoing routine plasma exchanges (PE: membrane plasma filtration: n = 4, and centrifugation: n = 4) were used in the studies. Plasma flow rate was 20 ml/min, and plasma perfusion in single pass was terminated when the transmembrane pressure of the filter reached 300 mm Hg. Solute concentration data from before and after perfusion were used to assess the sieving coefficient (SC) of each solute. Results show that the SCs for anti-AChR Ab and albumin were significantly (P < .0002) lower at 4 degrees C (0.15 and 0.52, respectively) as compared to 37 degrees C (0.44 and 0.72, respectively). The SC of anti-AChR Ab (0.15) was significantly lower than the SC of IgG (0.42; P < .006) at 4 degrees C, even though it also belongs to the IgG class. The ratio of the SC of anti-AChR Ab to albumin at 4 degrees C (0.29) was significantly lower than that at 37 degrees C (0.57; P < .003). These data indicate that the selectivity of removal of anti-AChR Ab from albumin is higher at 4 degrees C than that at 37 degrees C. The volume treated at 4 degrees C was significantly lower than that treated at 37 degrees C, and it was less than that required for a clinical treatment; however, it was shown that filter backwashing is possible without loss of solute removal selectivity.(ABSTRACT TRUNCATED AT 250 WORDS)
authors.affiliation: Department of Biomedical Engineering & Applied Therapeutics, Cleveland Clinic Foundation, Ohio.
authors.forename: K
authors.initials: K
authors.lastname: Sawada
authors.forename: P S
authors.initials: PS
authors.lastname: Malchesky
authors.forename: M
authors.initials: M
authors.lastname: Zborowski
authors.forename: A P
authors.initials: AP
authors.lastname: Koo
mesh_terms: D000906:Antibodies / Q000302:isolation & purification*; D005591:Chemical Fractionation; D003080:Cold Temperature; D006801:Humans; D008567:Membranes, Artificial; D009157:Myasthenia Gravis / Q000097:blood; D010949:Plasma / Q000276:immunology*; D011950:Receptors, Cholinergic / Q000276:immunology*; D012709:Serum Albumin / Q000302:isolation & purification
chemical_list: D000906:Antibodies; D008567:Membranes, Artificial; D011950:Receptors, Cholinergic; D012709:Serum Albumin