学術雑誌論文 関節リウマチ・悪性関節リウマチに対するアフェレシス療法(<特集>血管炎症候群とアフェレシス)
Therapeutic Apheresis in the Treatment of Rheumatoid Arthritis

日高, 利彦  ,  Toshihiko, Hidaka  ,  医療法人社団善仁会市民の森病院膠原病・リウマチセンター  ,  Institute of Rheumatology, Zenjinkai Shimin-no-mori Hospital

内容記述
We have many procedures of an apheresis therapy for rheumatoid arthritis (RA); plasma exchange, double filtration plasmapheresis, cryofiltration plasmapheresis, immunoadsorption plasmapheresis, granulocytapheresis and leukocytapheresis (LCAP). In this article, we discussed these apheresis therapies, especially LCAP. A simple and practical on-line continuous LCAP system has recently been developed. It is equipped with a direct hemoperfusion column (Cellsorba^[○!R], Asahikasei Medical Co., Ltd.) packed with fine-diameter polyester fibers, which are commonly used to adsorb white blood cells to prevent a graft-versus-host reaction during blood transfusion. Clinical trials revealed that LCAP is a safe and effective therapy for patients with drug-resistant RA or RA complicated with vasculitis. Because the procedure is simple and requires no plasma substitutes and the volume needed for extracorporeal circulation is less than that for plasmapheresis, LCAP might be accepted as an optional therapeutic modality for drug-resistant RA. The mechanism of the efficiency of LCAP on RA is unclear. LCAP may cause a reduction of activated T cells from affected joints, down-regulation of Pgp on helper T cells and restoration of Treg function, and that may modify the abnormal cytokine balance. These findings may explain some of the mechanisms by which the articular symptoms are improved by LCAP.
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https://projects.repo.nii.ac.jp/?action=repository_action_common_download&item_id=152407&item_no=1&attribute_id=21&file_no=1

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