title: Stool decay-accelerating factor as a marker for monitoring the disease activity during leukocyte apheresis therapy in patients with refractory ulcerative colitis.
abstract: OBJECTIVE
  We have shown previously that concentrations of stool decay-accelerating factor (DAF; CD55), a complement regulatory protein, in patients with ulcerative colitis (UC) are increased in relation to the severity of the colonic mucosal inflammation. In the present study, we evaluated the usefulness of stool DAF as a marker for monitoring disease activity in patients with steroid-resistant active UC being treated with leukocyte apheresis performed with a centrifugal cell separator.
  
  
  METHODS
  Twenty-one patients with active and steroid-resistant UC were treated with leukocyte apheresis once a week for 4 weeks, and stool DAF concentrations were determined weekly by immunoassay.
  
  
  RESULTS
  After treatment, 11 (52%) of the 21 UC patients went into remission. Stool DAF concentrations decreased promptly and steadily in the responsive group. The difference reached statistical significance as soon as after the second apheresis session (P < 0.003), compared with values before the therapy and corresponding values in the non-responsive group (P = 0.024). The reduction in stool DAF concentrations after the second apheresis session was significantly greater in the responsive group (median 90%, range 22-90%) than in the non-responsive group (median -13%, range -307-94%) (P = 0.008). Hematological tests, that is, white blood cell (WBC) count and C-reactive protein, declined significantly during the apheresis therapy, but not in relation to therapeutic response.
  
  
  CONCLUSIONS
  Stool DAF concentration is a useful marker in the clinical response of UC patients to treatment with leukocyte apheresis.
authors.affiliation: Department of Medicine and Medical Science (Medicine 1), Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kohno
authors.forename: Motowo
authors.initials: M
authors.lastname: Mizuno
authors.forename: Junichirou
authors.initials: J
authors.lastname: Nasu
authors.forename: Chiho
authors.initials: C
authors.lastname: Makidono
authors.forename: Sakiko
authors.initials: S
authors.lastname: Hiraoka
authors.forename: Tomoki
authors.initials: T
authors.lastname: Inaba
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Yamamoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Okada
authors.forename: Teizo
authors.initials: T
authors.lastname: Fujita
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000032:analysis; D018958:CD55 Antigens / Q000032:analysis* / Q000096:biosynthesis; D003093:Colitis, Ulcerative / Q000378:metabolism / Q000628:therapy*; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged
chemical_list: D015415:Biomarkers; D018958:CD55 Antigens