Granulocyte and monocyte apheresis suppresses symptoms of rheumatoid arthritis: a pilot study.
To investigate if granulocyte and monocyte apheresis mitigates the symptoms of rheumatoid arthritis (RA), and influences production of panmyelocytes (CD15+ CD16- cells) at the bone marrow level, 27 RA patients who had elevated granulocyte counts were recruited. The granulocyte and monocyte apheresis column (G-1 column) is an extracorporeal type device packed with 220 g cellulose acetate beads to which granulocytes and monocytes specifically adhere. Patients received apheresis of 1 hr duration twice per week, 8 times over a period of 4 weeks. To prepare CD15+CD16- cells, iliac bone marrow aspirate was obtained at baseline and at 2 weeks after completion of the apheresis course. Ex-vivo proliferation of bone marrow low density cells and production of IgM-RF were also investigated. Following granulocyte and monocyte apheresis, there was a suppressed tendency in the number of CD15+CD16- cells in patients with high bone marrow CD15+CD16- cell counts at baseline. Clinical assessments 2 weeks after the completion of apheresis therapy showed improvements in swollen joint count (P < 0.001), tender joint count (P < 0.001) and duration of morning stiffness (P < 0.005). The results suggest that granulocytes and monocytes/macrophages have a pathological role in RA and apheresis treatment to reduce or suppress these cells should benefit patients with RA.
Nagashima
M
M
Department of Joint Disease and Rheumatism, Nippon Medical School, Tokyo, Japan.
Yoshino
S
S
Tanaka
H
H
Yoshida
N
N
Kashiwagi
N
N
Saniabadi
A R
AR
D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000378:metabolism / Q000628:therapy*; D001804:Blood Transfusion, Autologous; D016207:Cytokines / Q000378:metabolism; D005260:Female; D005434:Flow Cytometry; D006098:Granulocytes; D006801:Humans; D007937:Leukapheresis; D007958:Leukocyte Count; D017708:Leukocyte Transfusion; D016256:Lewis X Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009000:Monocytes; D010865:Pilot Projects; D017452:Receptors, IgG / Q000378:metabolism; D012217:Rheumatoid Factor / Q000378:metabolism; D016896:Treatment Outcome
D016207:Cytokines; D016256:Lewis X Antigen; D017452:Receptors, IgG; D012217:Rheumatoid Factor