[Mechanism of leukocytapheresis effect in the treatment of ulcerative colitis].
To solve adverse effects of high dose steroid administration for patients with moderately severe and severe ulcerative colitis (UC), additional use of leukocytapheresis (LCAP) was tried to settle colonic inflammation. We evaluated immunological changes in the treatment of LCAP using leukocyte removal filter for UC patients. We then assessed the clinical effectiveness of LCAP compared with that of high dose of steroid therapy. LCAP removed monocytes, granulocytes, and lymphocytes presenting CD 11 b+, CD 11 c+, and HLADR+, selectively from the patients. Proinflammatory cytokine productions measured such as TNF alpha, IL-1 beta, and IL 8 reduced and IL 10 increased immediately after LCAP compared with before perfusion. Improved rate was about 70% for LCAP group and about 40% for high dose steroid group (Refer J Gastroenterol). Selective removal of granulocyte, monocytes, and activated lymphocytes inhibits proinflammatory cytokine production and increases immune modulating cytokine productions (Refer Therapeutic Apheresis). Then quick inhibition of several inflammatory deteriorated factors simultaneously controls the activity and clinical symptoms of UC with less severe adverse effects. It can be considered one option for treatment of UC.
Sawada
K
K
Dept. of Internal Medicine IV, Hyogo College of Medicine.
Ohnishi
K
K
Fukunaga
K
K
Chikano
S
S
Egashira
A
A
Satomi
M
M
Shimoyama
T
T
D000328:Adult; D003093:Colitis, Ulcerative / Q000628:therapy*; D005260:Female; D006801:Humans; D007937:Leukapheresis; D011239:Prednisolone / Q000627:therapeutic use
D011239:Prednisolone