Acute and chronic effects of therapeutic apheresis.
In most patients only a few sessions of apheresis treatment are necessary to see the benefit. This is the case of immunological diseases when the production of a pathologic component is limited in time or in microcirculation disturbances when changes of vascular function may occur. In the first instance the acute effect is likely due to the removal of the corresponding antibody, while in the second case the improvement of the endothelium-dependent vasodilation and the reduction of blood viscosity play a major role. In long-term treatment, as in the case of patients affected by familial hypercholesterolemia, the chronic effects of apheresis may lead to the repair of morphological alterations in the vascular wall. We report the recovery from ulcers in two hemodialysis patients suffering from peripheral arterial disease as the result of twenty-two sessions of rheopheresis. The reasons that justify these chronic actions may involve pleiotropic effects that are different according to the apheresis technique used.
Section of Nephrology, Dept of Internal and Public Medicine, University of Bari, Bari, Italy. a.ramunni@nephro.uniba.it
Alfonso
A
Ramunni
Francesco
F
Petrarulo
Costanzo
C
Grasso
Sergio
S
Papagni
Paola
P
Brescia
D015415:Biomarkers / Q000097:blood; D001781:Blood Component Removal / Q000009:adverse effects; D008078:Cholesterol, LDL / Q000097:blood*; D016523:Foot Ulcer / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D006938:Hyperlipoproteinemia Type II / Q000097:blood / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008833:Microcirculation; D058729:Peripheral Arterial Disease / Q000097:blood / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D012008:Recurrence; D012307:Risk Factors; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014945:Wound Healing
D015415:Biomarkers; D008078:Cholesterol, LDL