title: Removal kinetics of antibodies against glutamic acid decarboxylase by various plasmapheresis modalities in the treatment of neurological disorders.
abstract: Plasmapheresis is one of the acute treatment modalities for neurological disorders associated with antibodies against glutamic acid decarboxylase (anti-GAD). However, there is little information about the removal kinetics of anti-GAD by various plasmapheresis modalities. Here, we investigated the removal rate of anti-GAD and fibrinogen (Fib) by immunoadsorption (IA), plasma exchange using a conventional plasma separator (OP-PE), and plasma exchange using a high cut-off selective membrane plasma separator (EC-PE) in two cases of anti-GAD-associated neurological diseases. In case 1, IA and OP-PE were used, and the percent reductions were as follows: anti-GAD: 38.2% and 69.1% and Fib: 67.7% and 68.2%, respectively. In case 2, OP-PE and EC-PE were used, and the percent reductions were as follows: anti-GAD: 65.8% and 48.5% and Fib: 68.5% and 19.8%, respectively. OP-PE could remove anti-GAD more efficiently than IA. Further, EC-PE could maintain coagulation factors such as Fib better than IA and OP-PE. It is important to select the appropriate plasmapheresis modality on the basis of the removal kinetics.
authors: Medical Engineering Center, Medical Hospital of Tokyo Medical and Dental University, Tokyo, Japan.
authors: Atsushi
authors: A
authors: Ohkubo
authors: Tomokazu
authors: T
authors: Okado
authors: Naoki
authors: N
authors: Kurashima
authors: Takuma
authors: T
authors: Maeda
authors: Satoko
authors: S
authors: Miyamoto
authors: Ayako
authors: A
authors: Nakamura
authors: Hiroshi
authors: H
authors: Seshima
authors: Soichiro
authors: S
authors: Iimori
authors: Eisei
authors: E
authors: Sohara
authors: Shinichi
authors: S
authors: Uchida
authors: Tatemitsu
authors: T
authors: Rai
mesh_terms: D000328:Adult; D000906:Antibodies / Q000276:immunology*; D001779:Blood Coagulation Factors / Q000378:metabolism; D005260:Female; D005340:Fibrinogen / Q000378:metabolism; D005968:Glutamate Decarboxylase / Q000276:immunology*; D006801:Humans; D007163:Immunosorbent Techniques; D008875:Middle Aged; D009422:Nervous System Diseases / Q000276:immunology / Q000628:therapy*; D010956:Plasmapheresis / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000906:Antibodies; D001779:Blood Coagulation Factors; D005340:Fibrinogen; D005968:Glutamate Decarboxylase
keywords: Antibodies; Glutamic acid decarboxylase; Immunoadsorption; Membrane plasma separator; Plasma exchange; Removal kinetics