title: More selective removal of myeloperoxidase-anti-neutrophil cytoplasmic antibody from the circulation of patients with vasculitides using a novel double-filtration plasmapheresis therapy.
abstract: Our aim was to investigate the removal of myeloperoxidase-anti-neutrophil cytoplasmic antibody (MPO-ANCA) from the circulation of patients with vasculitides by double-filtration plasmapheresis (DFPP) using various primary separator and secondary separator combinations. Nineteen patients diagnosed with vasculitides positive for serum MPO-ANCA were enrolled and received 56 sessions of DFPP. One patient received three sessions of DFPP using MPS07 (the primary filter)/EC50W (the secondary filter), nine patients received 27 sessions of DFPP using MPS07/EC20W, and the other nine patients received 26 sessions of DFPP using EC50W/EC20W. The sieving coefficients (SC) of albumin, immunoglobulin (Ig)A, IgG and IgM were measured, as well as the reduction ratio in plasma protein concentrations and MPO-ANCA titer after a single session of DFPP. The MPS07 filter was well permeable for all the above-mentioned plasma proteins; the EC50W and EC20W filters were permeable for albumin and IgG, less for IgA and IgM. During DFPP using MPS07/EC50W, the reduction ratio of IgG was much lower than IgM and IgA (30.5 ± 9.0% vs. 89.7 ± 5.4% and 61.7 ± 14.8%). During DFPP using MPS07/EC20W, the decline in IgM, IgA, and IgG was 94.2 ± 3.1%, 96.2 ± 2.3%, and 64.7 ± 21.0%, respectively. During DFPP using EC50W/EC20W, the decline in IgM, IgA, and IgG was 2.8 ± 12.9%, 90.9 ± 4.4%, and 43.5 ± 13.8%, respectively. The percentage reduction in MPO-ANCA titer after a single session of DFPP using EC50W/EC20W was 34.6 ± 14.3%. DFPP using EC50W/EC20W filters may be more selective for the removal of pathogens such as IgG, with subsequently effective reduction of serum ANCA titer.
authors: Research Institute of Nephrology, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China.
authors: Dehua
authors: D
authors: Gong
authors: Daxi
authors: D
authors: Ji
authors: Bin
authors: B
authors: Xu
authors: Zhihong
authors: Z
authors: Liu
mesh_terms: D000328:Adult; D000368:Aged; D056648:Anti-Neutrophil Cytoplasmic Antibody-Associated Vasculitis / Q000628:therapy*; D019268:Antibodies, Antineutrophil Cytoplasmic / Q000097:blood*; D005374:Filtration; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood; D007074:Immunoglobulin G / Q000097:blood; D007075:Immunoglobulin M / Q000097:blood; D008297:Male; D008875:Middle Aged; D009195:Peroxidase / Q000097:blood*; D010865:Pilot Projects; D010956:Plasmapheresis / Q000379:methods*; D011446:Prospective Studies
chemical_list: D019268:Antibodies, Antineutrophil Cytoplasmic; D007070:Immunoglobulin A; D007074:Immunoglobulin G; D007075:Immunoglobulin M; D009195:Peroxidase