Current status in extracorporeal immunomodulation: immune disorders.
Today, clinicians can choose from a variety of extracorporeal immunomodulatory procedures such as plasma exchange, double filtration, immunoadsorption, chemoadsorption, photopheresis, and cytoapheresis. The mechanisms underlying extracorporeal immunomodulation (ECIM) comprise removal of pathogenic antibodies and circulating immune complexes as well as reticuloendothelial system deblockage; modification of immune complex structure and processing can be induced by changing the antigen/antibody ratio and by modulation of immune complex solubility via complement activation. Finally, cellular components like lymphocyte subsets, can be modified. Clinical examples of ECIM include lupus erythematosus, Goodpasture's syndrome, anti-neutrophil cytoplasmatic antibodies-mediated systemic vasculitis, myasthenia gravis, and, hypothetically, sepsis.
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Nephrological Department, Klinikum Grosshadern, University of Munich, Germany.
D000276:Adjuvants, Immunologic / Q000494:pharmacology / Q000592:standards / Q000627:therapeutic use*; D019867:Anti-Glomerular Basement Membrane Disease / Q000276:immunology / Q000628:therapy; D000936:Antigen-Antibody Complex / Q000276:immunology; D001781:Blood Component Removal / Q000592:standards / Q000639:trends; D002986:Clinical Trials as Topic; D006801:Humans; D007164:Immunosorbents / Q000592:standards / Q000627:therapeutic use*; D008180:Lupus Erythematosus, Systemic / Q000276:immunology / Q000628:therapy; D009157:Myasthenia Gravis / Q000276:immunology / Q000628:therapy; D010951:Plasma Exchange / Q000592:standards* / Q000639:trends; D018805:Sepsis / Q000276:immunology / Q000628:therapy; D013601:T-Lymphocytes / Q000166:cytology / Q000187:drug effects* / Q000276:immunology; D014657:Vasculitis / Q000276:immunology / Q000628:therapy
D000276:Adjuvants, Immunologic; D000936:Antigen-Antibody Complex; D007164:Immunosorbents