title: Therapeutic immunoadsorption increases the level of circulating soluble HLA molecules.
abstract: OBJECTIVE
  Immunoadsorption (IA) is an established procedure to remove Igs and immune complexes from peripheral blood. Since Igs reportedly bind to human leucocyte antigen (HLA) molecules, we were interested to know whether removal of Ig will also influence the plasma concentration of soluble HLA (sHLA).
  
  
  METHODS
  Nine patients suffering from severe autoimmune disease and undergoing 17 single courses of IA treatment were monitored for their sHLA class I (sHLA-I) and sHLA-DR plasma levels. Plasma was separated by a hollow-fiber-type separator. Plasma samples were taken before therapy, after 15 min of recirculation (without operating the adsorber), after 1 and 2 liters of plasma adsorption, and 24 and 48 h after the end of IA.
  
  
  RESULTS
  Before treatment the mean levels of sHLA-I and sHLA-DR were 0.37 (+/-0.06 SEM) and 0. 32+/-0.05 microg/ml, respectively. After 2 liters of plasma filtration, an increase in sHLA-DR (0.80+/-0.10 microg/ml) was observed (p<0.001), whereas sHLA-I was only slightly affected (mean: 0.45+/-0.06 microg/ml). sHLA concentrations returned to initial levels after 24 h.
  
  
  CONCLUSIONS
  The significant increase in sHLA-DR may contribute to the immunomodulatory effect of IA.
authors.affiliation: Sauerlandklinik Hachen, Neurologische Spezialklinik, Sundern-Hachen, Germany. dieterpoehlau@compuserve.com
authors.forename: D
authors.initials: D
authors.lastname: Poehlau
authors.forename: U
authors.initials: U
authors.lastname: Kiltz
authors.forename: M
authors.initials: M
authors.lastname: Rieks
authors.forename: V
authors.initials: V
authors.lastname: Hoffmann
authors.forename: V
authors.initials: V
authors.lastname: Rebmann
authors.forename: S
authors.initials: S
authors.lastname: Schimrigk
authors.forename: H
authors.initials: H
authors.lastname: Grosse-Wilde
authors.forename: H
authors.initials: H
authors.lastname: Przuntek
mesh_terms: D000936:Antigen-Antibody Complex / Q000097:blood; D001327:Autoimmune Diseases / Q000097:blood / Q000628:therapy; D006680:HLA Antigens / Q000097:blood*; D006684:HLA-DR Antigens / Q000097:blood; D015395:Histocompatibility Antigens Class I / Q000097:blood; D006801:Humans; D007136:Immunoglobulins / Q000097:blood; D007163:Immunosorbent Techniques; D012995:Solubility
chemical_list: D000936:Antigen-Antibody Complex; D006680:HLA Antigens; D006684:HLA-DR Antigens; D015395:Histocompatibility Antigens Class I; D007136:Immunoglobulins