Immunomodulation effects and clinical evidence of apheresis in renal diseases.
This article overviews the immunomodulation effects and clinical evidence of apheresis in renal diseases, in particular primary and secondary glomerulonephritis. A considerable permeability factor(s) derived from circulating T cells is speculated to have a crucial role in the proteinuria of nephrotic syndrome (NS). Plasma exchange (PE), immunoadsorption using Protein A sepharose cartridges, low-density lipoprotein apheresis and lymphocyte apheresis (LCAP) were tried to remove such factors or pathogenic T cells. Other glomerular diseases induced by specific antibodies such as antiglomerular basement membrane antibodies, antineutrophil cytoplasmic antibodies and immune-complexes such as lupus nephritis were also treated with PE, double filtration plasma apheresis. IAPP and LCAP. Many reports suggested that apheresis might have beneficial immunomodulation effects for the treatment of glomerular diseases: however, the recommendations based on evidence from small cohorts remain at low-level in most.
Yokoyama
Hitoshi
H
Department of Gastroenterology and Nephrology and Division of Blood Purification, Kanazawa University Graduate School of Medical Science, Kanazawa University Hospital, Kanazawa, Japan. dialysis@medf.m.kanazawa-u.ac.jp
Wada
Takashi
T
Furuichi
Kengo
K
D019268:Antibodies, Antineutrophil Cytoplasmic / Q000032:analysis / Q000276:immunology*; D001781:Blood Component Removal; D005260:Female; D005921:Glomerulonephritis / Q000276:immunology / Q000628:therapy; D006801:Humans; D007107:Immune System / Q000502:physiology*; D007674:Kidney Diseases / Q000276:immunology* / Q000628:therapy*; D008181:Lupus Nephritis / Q000276:immunology / Q000628:therapy; D008297:Male; D009404:Nephrotic Syndrome / Q000276:immunology / Q000628:therapy; D011379:Prognosis; D006435:Renal Dialysis / Q000379:methods; D018570:Risk Assessment; D012680:Sensitivity and Specificity
D019268:Antibodies, Antineutrophil Cytoplasmic