Stool decay-accelerating factor as a marker for monitoring the disease activity during leukocyte apheresis therapy in patients with refractory ulcerative colitis.
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.
Kohno
Hiroyuki
H
Department of Medicine and Medical Science (Medicine 1), Okayama University Graduate School of Medicine and Dentistry, Okayama, Japan.
Mizuno
Motowo
M
Nasu
Junichirou
J
Makidono
Chiho
C
Hiraoka
Sakiko
S
Inaba
Tomoki
T
Yamamoto
Kazuhide
K
Okada
Hiroyuki
H
Fujita
Teizo
T
Shiratori
Yasushi
Y
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
D015415:Biomarkers; D018958:CD55 Antigens