Granulocytapheresis in the treatment of patients with rheumatoid arthritis.
The G-1 column is an extracorporeal type granulocytapheresis device packed with 220 g cellulose acetate beads to which granulocytes and monocytes specifically adhere. A total of 59 rheumatoid arthritis patients with elevated granulocyte counts from 4 hospitals in Japan received 2 apheresis sessions of 1 h duration/week for a total of 8 times over a period of 4 weeks. About 55% of the leukocytes which entered the G-1 column were adsorbed onto the beads: 95% were granulocytes, 3.5% monocytes, and 0.4% lymphocytes. Clinical and efficacy assessments showed improvements in swollen joints (p < 0.01), tender joints (p < 0.001), the active joint score (p < 0.001), duration of morning stiffness (p < 0.01), and grip strength (p < 0.001). In good responders, the improvements were observed for up to 12 weeks following the last apheresis. Exacerbation was noted in 2 patients. It is suggested that the efficacy of the G-1 column is attributable to the removal or suppression of hyperactive leukocytes and inflammatory cytokines, inducing a kind of immunomodulation.
Ohara
M
M
Department of Internal Medicine II, Fukushima Medical College, Fukushima City, Japan.
Saniabadi
A R
AR
Kokuma
S
S
Hirata
I
I
Adachi
M
M
Agishi
T
T
Kasukawa
R
R
D000327:Adsorption; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000473:pathology / Q000628:therapy*; D001798:Blood Proteins / Q000032:analysis; D002482:Cellulose / Q000031:analogs & derivatives; D016238:Cytapheresis / Q000379:methods*; D005260:Female; D006098:Granulocytes; D006801:Humans; D015850:Interleukin-6 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
D001798:Blood Proteins; D015850:Interleukin-6; D016209:Interleukin-8; D014409:Tumor Necrosis Factor-alpha; C005062:acetylcellulose; D002482:Cellulose