Immunoadsorption therapy for myasthenia gravis.

Shibuya, Noritoshi; Satô, Tadashi; Osame, Mitsuhiro; Takegami, Toshihiko; Doi, Shizuki; Kawanami, Satoshi

doi:10.1136/jnnp.57.5.578

Cited by 88 publications

(75 citation statements)

References 17 publications

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“…Plasma adsorption therapy is a treatment for various autoimmune diseases such as Myasthenia gravis, Guillain-Barre syndrome and Multiple sclerosis 16,17 . It is also used to treat fulminant hepatitis and postoperative liver failure.…”

Section: Tools and Devicesmentioning

confidence: 99%

Plasma Adsorption Membranes Are Able to Efficiently Remove High Mobility Group Box-1 (HMGB-1)

2018

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Background: High Mobility Group Box 1 (HMGB-1) is a 30 kDa protein that is a lethal mediator in sepsis and is a recognized therapeutic target. However, no consensus has been reached for acute blood purification therapy as a treatment for sepsis targeting HMGB-1. Previous studies demonstrated that a high anti-HMGB-1 antibody titer and the suppression of HMGB-1 activity improved survival rate in animal sepsis models. The aim of this study was to evaluate whether plasma adsorption therapy is able to decrease the level of HMGB-1, representing a new potential treatment strategy against sepsis.Methods: Plasma adsorption therapy has been known as a treatment for various autoimmune diseases.Three different adsorbent columns, including TR-350 (IM-TR), PH-350 (IM-PH), and BRS-350 (BRS), were used in this study for comparison.We made a 1/350 scale of these three columns. Fetal bovine serum (FBS) contains a significant amount of HMGB-1. After priming with saline, FBS was passed through the columns and the adsorption rates of HMGB-1 at 25 minutes, 50 minutes, and 75 minutes were evaluated. The total adsorbed HMGB-1 level at 75 minutes was also calculated. Results:The highest adsorption rate and total adsorbed amount of HMGB-1 were observed in IM-TR, followed by BRS and IM-PH. IM-TR showed a decline in adsorption rate over time. BRS showed a steady adsorption rate at all time points. IM-TR removed HMGB-1 significantly more than IM-PH and BRS.Conclusions: Our findings showed that plasma adsorption therapy efficiently adsorbed HMGB-1 and could be safely applied for the treatment of sepsis. (J Nippon Med Sch 2018; 85: 150 156)

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Section: Tools and Devicesmentioning

confidence: 99%

Plasma Adsorption Membranes Are Able to Efficiently Remove High Mobility Group Box-1 (HMGB-1)

2018

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“…A different kind of semiselective immunoadsorption uses filters containing tryptophanlinked polyvinyl alcohol gel, used to treat Myasthenia Gravis patients with promising initial results in terms of clinical improvement (Grob et al, 1995;Shibuya et al, 1994). The binding is mediated by a chemical interaction and is much less selective than protein A or sheep anti-human immunoglobulin since other plasma components are retained, particularly fibrinogen and complement.…”

Section: Semiselective Immunoadsorptionmentioning

confidence: 99%

Immunomodulatory Treatments for Myasthenia Gravis: Plasma Exchange, Intravenous Immunoglobulins and Semiselective Immunoadsorption

Baggi¹,

Antozzi²

2012

A Look Into Myasthenia Gravis

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“…15,16 Plasma exchange in neuromyelitis optica Neuromyelitis optica (NMO), or Devic's disease, is an increasingly better understood demyelinating disease of the central nervous system (CNS). It predominantly involves the optic nerve and the spinal cord, where the white as well as gray matter can be affected.…”

Section: Plasmapheresis Versus Immunoadsorption Techniquesmentioning

confidence: 99%

Plasmapheresis for neuroinflammatory disorders

Schröder

Linker

Gold

2010

Clinical & Exp Neuroim

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Nowadays, therapeutic plasma exchange (PE) is the most common apheresis procedure. Plasma is separated from corpuscular blood constitutents and replaced with a substitution fluid. Thus, PE is a non‐specific treatment modality. Its therapeutic effect is based on the removal of circulating, pathogenic immune factors, including autoantibodies. To date, PE is well established for several immune mediated neurological disorders. Whilst the first experience was acquired in acute life‐threatening conditions, such as the treatment of Guillain–Barré syndrome or myasthenic crisis, therapeutic success was later achieved in other chronic autoimmune diseases; PE was applied successfully in chronic inflammatory demyelinating polyneuropathy, paraproteinaemic polyneuropathy, stiff‐person syndrome and might also be tried in autoimmune diseases of paraneoplastic origin. From a novel aspect, PE was also established as an escalation therapy for steroid unresponsive relapses of multiple sclerosis, and thus has gained even more widespread attention. Humoral disease mechanisms dominate even more in neuromyelitis optica, as a subtype of MS, and usually respond to PE. Adding to its increasing application in clinical practice, the procedure is usually well tolerated. Possible adverse reactions of PE arise from the large‐size vascular access site, the use of replacement fluids and the need for anticoagulation. (Clin. Exp. Neuroimmunol. doi: 10.1111/j.1759‐1961.2010.0010.x, 2010)

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Immunoadsorption therapy for myasthenia gravis.

Cited by 88 publications

References 17 publications

Plasma Adsorption Membranes Are Able to Efficiently Remove High Mobility Group Box-1 (HMGB-1)

Plasma Adsorption Membranes Are Able to Efficiently Remove High Mobility Group Box-1 (HMGB-1)

Immunomodulatory Treatments for Myasthenia Gravis: Plasma Exchange, Intravenous Immunoglobulins and Semiselective Immunoadsorption

Plasmapheresis for neuroinflammatory disorders

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