A large-scale, prospective, observational study of leukocytapheresis for ulcerative colitis: Treatment outcomes of 847 patients in clinical practice

Yokoyama, Yoko; Matsuoka, Katsuyoshi; Kobayashi, Taku; Sawada, Koji; Fujiyoshi, T.; Ando, Takafumi; Ohnishi, Yozo; Ishida, Tetsuya; Oka, Masashi; Yamada, Masahiro; Nakamura, Takashi; Ino, Tomoko; Numata, Toyoko; Aoki, Hirofumi; Sakou, Jun ichi; Kusada, Masahiro; Maekawa, Tomoki; Hibi, Toshifumi

doi:10.1016/j.crohns.2014.01.027

Cited by 48 publications

(55 citation statements)

References 35 publications

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“…In all 3 cases, the use of GMA appears to have enhanced the effect of immunosuppressive drugs, thus allowing for the long‐term removal of corticosteroids and the achievement of mucosal healing while receiving maintenance therapy with infliximab and azathioprine. These findings have encouraged us to reconsider the utility of GMA in severe UC and to further explore the potential immunomodulatory effects associated with this technique . We have also taken into account the possible placebo effect of this extracorporeal treatment, as previously observed by other authors, though the clinical improvement in all 3 patients after the apheresis sessions appears to be more related to the therapeutic effect of apheresis than a placebo effect …”

Section: Discussionmentioning

confidence: 79%

“…The primary indications for GMA appear to be steroid resistance with mild to moderate activity or steroid dependence. GMA could also be considered an alternative option to steroid treatment in patients with contraindications for the use of steroids; however, its clinical efficacy in severe forms of the disease is more limited . The mechanisms responsible for improvement after GMA therapy are not fully understood; however, changes in immune cell populations and cytokine levels have been suggested to play an important role.…”

Section: Introductionmentioning

confidence: 99%

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Adsorptive granulocyte/monocyte apheresis use in severe ulcerative colitis and determination of changes in plasma cytokines

Beltrán

Saéz-González

Moret

et al. 2017

J of Clinical Apheresis

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Despite controversy regarding the use of granulocyte/monocyte adsorption (GMA) in inflammatory bowel disease, some studies have shown favorable outcomes when it is used in steroid-dependent patients with ulcerative colitis (UC). The mechanisms responsible for such outcomes are not well characterized, but changes in immune cell populations and cytokine levels have been suggested to play an important role. We report the cases of 3 patients with chronically active severe UC who underwent GMA due to an inadequate response to standard and rescue therapy, as well as changes to their plasma cytokine profile. All the patients presented severe UC that was only partially responsive to various immunosuppressive drugs, and they were, therefore, referred for colectomy; however, all 3 refused this option, which led to the compassionate use of GMA as a last therapeutic resort. Following GMA treatment, rapid normalization of the clinical, endoscopic and laboratory parameters was observed in all the patients. Despite having achieved a good response, most cytokines remained at high concentrations after GMA, and only two, IL-6 and IL-8, showed a clear decrease throughout the GMA sessions. In view of this outcome, we hypothesize that GMA can help to lower the inflammatory load, thereby enhancing the effect of biologic drugs. To confirm this hypothesis and explore further indications for GMA, we propose the need for research directed toward the characterization of immune cell populations and their specific cytokine production rather than global cytokine assessment. K E Y W O R D Scytokines, granulocyte and monocyte apheresis, ulcerative colitis

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Section: Discussionmentioning

confidence: 79%

Section: Introductionmentioning

confidence: 99%

Adsorptive granulocyte/monocyte apheresis use in severe ulcerative colitis and determination of changes in plasma cytokines

Beltrán

Saéz-González

Moret

et al. 2017

J of Clinical Apheresis

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“…U lcerative colitis (UC) is a principal type of inflammatory bowel disease (IBD), which mainly attacks the mucosal layer of the rectum and colon and makes erosion and ulceration (Pola et al, 2012;Yokoyama et al, 2014). Exhibited as repeated relapses and remission, UC is a chronic disease and has a rising incidence worldwide, especially in China (Feng et al, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…Mesenchymal stem cells (MSCs) are a subset of adult stem cells residing in many tissues, including bone marrow (BM), adipose tissue, umbilical cord blood, and dermis (Yokoyama et al, 2014). Besides their potential clinical application for the repair of damaged tissues, recent studies have tested MSCs as a treatment modality for inflammationrelated diseases, such as IBD (Hayashi et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

Adipose-Derived Mesenchymal Stem Cells Ameliorate Ulcerative Colitis Through miR-1236 Negatively Regulating the Expression of Retinoid-Related Orphan Receptor Gamma

Zhang

Jin

Lin

et al. 2015

DNA and Cell Biology

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Mesenchymal stem cells (MSCs) were reported to accelerate the curing of ulcerative colitis (UC). Altered expression of microRNAs (miRNAs) has recently revealed association with UC. However, the effect of adipose-derived MSCs (ASCs) on UC and the mechanism of how miRNAs regulate UC remain unclear. We investigated the effect of ASCs on 2,4,6-trinitrobenzenesulfonic acid (TNBS)-induced UC in rat colon tissues. qRT-PCR and immunofluorescence analyses were performed to monitor the expression of miR-1236 and its target molecule, retinoid-related orphan receptor γ (RORγ). Regulation of the expression of RORγ by miR-1236 was assessed using luciferase reporter construct assays and miR-1236 mimic transfection. The relationship between miR-1236 and RORγ was further investigated in HT29 cells induced by TNF-α. ASCs highly ameliorated UC and decreased the inflammation markers in rats with TNBS-induced UC. In addition, ASCs upregulated the expression of miR-1236 and decreased the expression of RORγ in the TNBS-induced rat model of UC. The luciferase reporter assay and bioinformatic analysis demonstrated that the expression of RORγ was directly targeted and regulated by miR-1236. Specifically, the expression of RORγ was suppressed by miR-1236 mimic and enhanced by miR-1236 inhibitor. Furthermore, we demonstrated that exogenous miR-1236 mimic could inhibit the expression of RORγ in HT29 cell induced by TNF-α. ASCs effectively alleviated UC in rats with the expression of miR-1236 alteration, and miR-1236 may play important roles in UC by downregulating the expression of RORγ.

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“…The disease is bifurcated into remitting and relapsing courses [2] and may have significant impact on the quality of life and personal burden through reduction in the ability to work [3, 4]. UC patients may require life-long treatment and have an increased risk of developing colorectal cancer [5, 6].…”

Section: Introductionmentioning

confidence: 99%

Huangqin‐Tang and Ingredients in Modulating the Pathogenesis of Ulcerative Colitis

Wang

Tang

Zhang

2017

Evidence-Based Complementary and Alternative Medicine

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Ulcerative colitis (UC) is the most common inflammatory bowel disease worldwide. Current therapies in UC cause limitations, and herb medicine provides an important choice for UC treatment. Huangqin-Tang (HQT) is a well-known classical traditional Chinese herbal formula and has been used in China for thousands of years. A large number of pharmacological studies demonstrated HQT and its ingredients to be effective in treating UC. Though the therapeutic effect has been evaluated, comprehensive up-to-date reviews in this field are not yet available. Here we aim to review our current understanding of HQT and its ingredients in treating UC and how the agents modulate the main pathogenesis of the disease, including the intestinal environment, immune imbalance, inflammatory pathways, and oxidative stress. The summary on this issue may provide better understanding of HQT and its ingredients in treating UC and possibly help in promoting its clinical application.

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A large-scale, prospective, observational study of leukocytapheresis for ulcerative colitis: Treatment outcomes of 847 patients in clinical practice

Abstract: This large-scale study indicates that leukocytapheresis, including intensive procedure, is a safe and effective therapeutic option for active ulcerative colitis.

Cited by 48 publications

References 35 publications

Adsorptive granulocyte/monocyte apheresis use in severe ulcerative colitis and determination of changes in plasma cytokines

Adsorptive granulocyte/monocyte apheresis use in severe ulcerative colitis and determination of changes in plasma cytokines

Adipose-Derived Mesenchymal Stem Cells Ameliorate Ulcerative Colitis Through miR-1236 Negatively Regulating the Expression of Retinoid-Related Orphan Receptor Gamma

Huangqin‐Tang and Ingredients in Modulating the Pathogenesis of Ulcerative Colitis

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