Adacolumn, an Adsorptive Carrier Based Granulocyte and MonocyteApheresis Device for the Treatment of Inflammatory and RefractoryDiseases Associated with Leukocytes

Therapeutic Apheresis and Dialysis - Tập 7 Số 1 - Trang 48-59 - 2003
Abby R. Saniabadi1, Hiroyuki Hanai2, Ken Takeuchi2, Kazuo Umemura2, Taro Adachi3, Chieko Shima3, Ingvar Bjarnason4, Robert Löfberg5
1Japan Immunoresearch Laboratories, Takasaki, Japan
2Department of Medicine, Hamamatsu University, Hamamatsu, Japan,
3Japan Immunoresearch Laboratories, Takasaki
4King's College London
5Karolinska Institute at the IBD Unit, Sophiahemmet, Stockholm, Sweden

Tóm tắt

Abstract:  Apheresis has been recognized both economically and therapeuticallyas a novel approach for the treatment of inflammatory diseases,and certain others, which respond poorly to drug therapy. This reportis about Adacolumn, an adsorptive carrier based granulocyteand monocyte apheresis device with a volume of 335 mL,filled with about 220 g of cellulose acetate beads of 2 mmdiameter as the column adsorptive carriers. Pre‐ and post‐columnleukocyte counts have shown that the carriers adsorb about 65% ofgranulocytes, 55% of monocytes and 2% of lymphocytesfrom the blood in the column. Additionally, after apheresis, thereis a marked decrease in inflammatory cytokines (TNF‐α,IL‐1β, IL‐6 and IL‐8) produced by blood leukocytes,together with down‐modulation of l‐selectinand the chemokine receptor CXCR3. Adacolumn has been used to treatpatients with rheumatoid arthritis, ulcerative colitis and HIV infection. Typicalapheresis sessions have been 4–10, at a frequency of oneor two sessions per week. Treatment of patients with Adacolumn hasbeen associated with very promising efficacy and safety data. Accordingly,in Japan, Adacolumn has been approved by the Ministry of Healthfor the treatment of ulcerative colitis. Furthermore, Adacolumnmet the required quality and safety standards for medical devices andreceived an EC certification (CE‐mark) from TUV in 1999. However,although Adacolumn carriers are very efficient in depleting excessand activated granulocytes and monocytes/macrophages, theclinical efficacy associated with Adacolumn apheresis cannot befully explained on the basis of reducing granulocytes and monocytesper se. Hence, a long lasting effect on inflammatory cytokine generation,chemokine activities or immunomodulation is likely, but the precisemechanisms involved are not fully understood yet.

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Therapeutic Apheresis and Dialysis

Tập 7 Số 1

48-59

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