title: Decrease of reactive-oxygen-producing granulocytes and release of IL-10 into the peripheral blood following leukocytapheresis in patients with active ulcerative colitis.
abstract: OBJECTIVE
  To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the peripheral blood and of the functions of the peripheral blood leukocytes in these patients.
  
  
  METHODS
  The subjects were 19 patients with active UC, with a mean clinical activity index (CAI) of 9.2. The LCAP was conducted using Cellsorba E. In each session of LCAP, 2-3 L of blood at the flow rate of 30-50 mL/min was processed. The treatment was carried out in approximately 1-h sessions, once a week, for 5-10 wk. Blood samples for determination of the cytokine levels were collected from the inflow side of the column (site of dehematization; at the start of LCAP) and outflow side of the column (at the end of LCAP). Blood samples for the determination of reactive-oxygen-producing cells were collected from the peripheral blood before and after LCAP.
  
  
  RESULTS
  LCAP resulted in clinical improvement in all the 19 patients of UC recruited for this study. Remission (CAI: < or = 4) was noted in 15 (79%) of the 19 patients. The blood level of the pro-inflammatory cytokine IL-6 was found to be decreased following treatment by LCAP, and the level of the anti-inflammatory cytokine IL-10 at the outflow side of the LCAP column was found to be significantly elevated as compared to that at the inflow side of the column. The reactive-oxygen-producing granulocytes in the peripheral blood of UC patients was increased as compared to that in healthy persons and the increase was found to be decreased following treatment by LCAP.
  
  
  CONCLUSIONS
  LCAP exerted a high therapeutic efficacy in patients with active UC. Our findings suggest that LCAP is associated with enhanced production of the inhibitory cytokine IL-10 to indirectly inhibit the functions of the inflammatory leukocytes, and that inflammation is also considerably attenuated by the direct removal of reactive-oxygen-producing neutrophils from the peripheral blood.
authors.affiliation: Department of Endoscopic and Photodynamic Medicine, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan. flw-1013@topaz.plala.or.jp
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Hanai
authors.forename: Takayuki
authors.initials: T
authors.lastname: Iida
authors.forename: Ken
authors.initials: K
authors.lastname: Takeuchi
authors.forename: Fumitoshi
authors.initials: F
authors.lastname: Watanabe
authors.forename: Yasuhiko
authors.initials: Y
authors.lastname: Maruyama
authors.forename: Masataka
authors.initials: M
authors.lastname: Kikuyama
authors.forename: Tatsuo
authors.initials: T
authors.lastname: Tanaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Kondo
authors.forename: Kou
authors.initials: K
authors.lastname: Tanaka
authors.forename: Kenji
authors.initials: K
authors.lastname: Takai
mesh_terms: D000328:Adult; D002452:Cell Count; D003093:Colitis, Ulcerative / Q000097:blood* / Q000628:therapy*; D005260:Female; D006098:Granulocytes / Q000378:metabolism*; D006801:Humans; D016753:Interleukin-10 / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood; D007937:Leukapheresis; D008297:Male; D008875:Middle Aged; D010100:Oxygen / Q000097:blood
chemical_list: D015850:Interleukin-6; D016753:Interleukin-10; D010100:Oxygen