Removal of immunoglobulins by a protein A versus an antihuman immunoglobulin G-based system: evaluation of 602 sessions of extracorporeal immunoadsorption.
Elimination of IgG can be achieved by extracorporeal immunoadsorption (IA) based on specific binding to either staphylococcal protein A (Excorim) or sheep polyclonal antibodies directed against human IgG (Therasorb). In 602 analyzed sessions of IA, elimination of IgG was 60% through 80% depending on the treated plasma volume, with no significant difference between the mentioned systems. However, the decrease of IgM and IgA was approximately 50% in the anti-IgG compared to 20-40% in the protein A system. Plasma albumin concentration decreased by 20% in the anti-IgG system compared to 15% in the protein A system, and hemoglobin values increased by 2% in the anti-IgG system and decreased by 6% in the protein A system. In conclusion, a clinical relevance for these findings cannot be ruled out, and the individual choice might depend on the clinical situation and laboratory findings.
Matic
G
G
Klinikum Südstadt; Dialysegemeinschaft Nord e.V.; Labor Müller, Rostock; and Müritz-Klinik, Klink, Germany.
Hofmann
D
D
Winkler
R
R
Tiess
M
M
Michelsen
A
A
Schneidewind
J M
JM
Hebestreit
G
G
Keysser
M
M
Müller
W
W
Kinze
E M
EM
Ramlow
W
W
D000888:Antibodies, Anti-Idiotypic / Q000627:therapeutic use*; D001781:Blood Component Removal; D001810:Blood Volume; D006438:Hemodilution; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood* / Q000276:immunology; D007075:Immunoglobulin M / Q000097:blood; D007163:Immunosorbent Techniques; D007164:Immunosorbents / Q000627:therapeutic use*; D010951:Plasma Exchange; D006435:Renal Dialysis; D012709:Serum Albumin / Q000032:analysis; D013205:Staphylococcal Protein A / Q000627:therapeutic use*
D000888:Antibodies, Anti-Idiotypic; D006454:Hemoglobins; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D007164:Immunosorbents; D012709:Serum Albumin; D013205:Staphylococcal Protein A