title: Adacolumn selective leukocyte adsorption apheresis in patients with active ulcerative colitis: clinical efficacy, effects on plasma IL-8, and expression of Toll-like receptor 2 on granulocytes.
abstract: Adacolumn selective granulocyte and monocyte apheresis (GMA) depletes activated leukocytes in patients with ulcerative colitis (UC). However, this per se cannot fully explain the efficacy of GMA. We have investigated the effects of GMA on the expression of toll-like receptors (TLRs) and plasma interleukin-8 (IL-8). Twenty-two patients with clinical activity index (CAI) of 5-17, 15 with total colitis and 7 with left-sided colitis, were included. Each patient could receive up to 10 GMA sessions, at 1 or 2 sessions per week. GMA was added to the patients' ongoing medication following a relapse or worsening UC, but no additional medication was given. Further, at entry and pre-GMA, blood samples were taken for full blood cell count, expression of TLRs on leukocytes, and plasma IL-8. Seventy-five percent of patients achieved remission after the 10th session (CAI, < or =4; P < 0.005) and there was a marked fall in C-reactive protein (P < 0.01), plasma IL-8 (P < 0.001), and granulocytes (P < 0.05) but an increase in lymphocytes (P < 0.05). The expression of TLR2 on granulocytes was down-modulated (P < 0.05) together with suppression of inflammatory cytokines produced by peripheral blood leukocytes. In conclusion, GMA appears to be an effective adjunct therapy to induce remission in the majority of patients, who are then spared from excess drug therapy. The procedure is associated with sustained immunomodulation. Control studies should strengthen these findings.
authors: Department of Internal of Medicine, Sakura Hospital, Toho University, 564-1 Shimoshizu, Sakura City, Chiba, Japan.
authors: Hiroshi
authors: H
authors: Aoki
authors: Kentaro
authors: K
authors: Nakamura
authors: Yasushi
authors: Y
authors: Yoshimatsu
authors: Yukiko
authors: Y
authors: Tsuda
authors: Masaki
authors: M
authors: Irie
authors: Katsuyuki
authors: K
authors: Fukuda
authors: Nobuo
authors: N
authors: Hosoe
authors: Nobuo
authors: N
authors: Takada
authors: Koji
authors: K
authors: Shirai
authors: Yasuo
authors: Y
authors: Suzuki
mesh_terms: D000293:Adolescent; D000328:Adult; D003093:Colitis, Ulcerative / Q000097:blood / Q000628:therapy*; D016207:Cytokines / Q000097:blood / Q000378:metabolism; D005260:Female; D006098:Granulocytes / Q000378:metabolism*; D006801:Humans; D016209:Interleukin-8 / Q000097:blood*; D007937:Leukapheresis; D007962:Leukocytes / Q000378:metabolism; D018655:Lymphocyte Count; D008297:Male; D008875:Middle Aged; D051195:Toll-Like Receptor 2 / Q000378:metabolism*
chemical_list: D016207:Cytokines; D016209:Interleukin-8; D051195:Toll-Like Receptor 2