Increased proliferation of blood mononuclear cells after plasmapheresis treatment of patients with demyelinating disease

Dau, Peter C.

doi:10.1016/0165-5728(90)90048-r

Cited by 31 publications

(17 citation statements)

References 24 publications

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“…In addition to removal of antineural antibodies, PP is suspected to reactivate macrophage function [11]or to increase proliferation of peripheral blood mononuclear cells [12], which could result in modulation of lymphocyte subsets in the peripheral blood. However, there have been no studies to investigate the changes of the altered T cell subsets in GBS patients treated with PP.…”

Section: Introductionmentioning

confidence: 99%

Lymphocyte Subset Proportions in Guillain-Barré Syndrome Patients Treated with Plasmapheresis

Yoshii

Shinohara

2000

Eur Neurol

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We examined the changes in the proportions of certain T cell subsets in 18 Guillain-Barré syndrome patients treated with plasmapheresis (PP). PP was performed within 8 days after the onset using a continuous-flow blood cell separator or immunoadsorption. The proportions of CD3+, CD4+ and CD4+CD45RA+ cells at the onset were decreased and that of CD19+ was increased compared with those of 25 normal controls. However, the proportions of CD4+CD45R–, CD4+HLADR+, CD4+CD25+ cells and the CD8+ subpopulations were similar in patients and controls. After PP, the altered subsets tended to normalize, particularly in the group that improved after PP.

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Section: Introductionmentioning

confidence: 99%

Lymphocyte Subset Proportions in Guillain-Barré Syndrome Patients Treated with Plasmapheresis

Yoshii

Shinohara

2000

Eur Neurol

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“…Multiple effects on the cellular components of the immune system have also been described. Plasmapheresis induces the proliferation of lymphocytes in patients with both MS and GBS, perhaps due to removal of an unknown lymphocyte suppression factor [323,324]. It is felt that the enhanced proliferation could augment the action of immunosuppressive drugs that target actively dividing lymphocytes.…”

Section: Plasmapheresismentioning

confidence: 99%

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Geldern¹,

McPharlin

Becker

2012

Neurotherapeutics

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This chapter will review the spectrum of immunemediated diseases that affect the nervous system and may result in an admission to the neurological intensive care unit. Immunomodulatory strategies to treat acute exacerbations of neurological diseases caused by aberrant immune responses are discussed, but strategies for long-term immunosuppression are not presented. The recommendations for therapeutic intervention are based on a synthesis of the literature, and include recommendations by the Cochrane Collaborative, the American Academy of Neurology, and other key organizations. References from recent publications are provided for the disorders and therapies in which randomized clinical trials and large evidenced-based reviews do not exist. The chapter concludes with a brief review of the mechanisms of action, dosing, and side effects of commonly used immunosuppressive strategies in the neurocritical care unit.

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“…A large number of studies have provided evidence for enhanced antibody synthesis after immunoglobulin depletion and thus for the existence of an immunoregulatory feedback mechanism. [1][2][3][4][5][6][7] In contrast, Charlton and colleagues [8][9][10] demonstrated with a series of animal experiments that the rapid increase of antibody serum levels after plasmapheresis could be explained by immunoglobulin backflow from extravascular space and decreased catabolism alone. More than 10 years later the lack of an increased antibody synthesis in a low immunoglobulin state was confirmed in the excellent studies by Junghans and Anderson 11 and by Junghans.…”

Section: Introductionmentioning

confidence: 99%

Influence of plasma immunoglobulin level on antibody synthesis

Goldammer

Derfler

Herkner

et al. 2002

Blood

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In previous experimental animal studies it has been demonstrated that antibody depletion is not followed by increased antibody synthesis. To assess whether these results are conferrable to antibody-depleted humans, we measured free light chains (flcs) as markers of current antibody synthesis in 8 patients treated with immunoadsorption (IA) therapy. Specific and bulk immunoglobulin levels were obtained simultaneously. The mean serum flc concentration increased to the preapheresis value within 1 day and remained unchanged thereafter. Total immunoglobulin G (IgG) and specific antibody concentrations increased to pretreatment values in 88% and 43% of the patients, respectively, and remained below the original values in the others. In conclusion, the lack of increased flc synthesis after IA confirms the absence of a feedback mechanism regulating antibody synthesis. IntroductionThe regulation of serum antibody levels has been a subject of debate for several decades. A large number of studies have provided evidence for enhanced antibody synthesis after immunoglobulin depletion and thus for the existence of an immunoregulatory feedback mechanism. [1][2][3][4][5][6][7] In contrast, Charlton and colleagues 8-10 demonstrated with a series of animal experiments that the rapid increase of antibody serum levels after plasmapheresis could be explained by immunoglobulin backflow from extravascular space and decreased catabolism alone. More than 10 years later the lack of an increased antibody synthesis in a low immunoglobulin state was confirmed in the excellent studies by Junghans and Anderson 11 and by Junghans. 12 Knock-out mice with disrupted immunoglobulin G (IgG) protection receptors, which effect increased catabolism of IgG and subsequently low IgG serum levels, had a similar biosynthesis rate as normal control subjects.The complex metabolism of IgG has so far prevented exact measurement of immunoglobulin synthesis in humans with low antibody levels. However, a prerequisite for immunoglobulin assembly is the synthesis of free light chains (flcs) that are produced in excess during antibody production and secreted as free or monomers into the vascular space. 13,14 Because flcs have a half-live of only 2 to 4 hours, 15 they reflect current immunoglobulin production and can be used for estimating the activity of diseases accompanied by autoantibody synthesis. 16,17 We hypothesized that increased antibody synthesis after immunoglobulin depletion would be accompanied by increased flc serum levels and measured free and light chain concentrations in 8 patients undergoing immunoadsorption (IA) therapy. Study designThe study protocol was approved by the local ethics committee, and the patients' informed consent was obtained. Eight patients with various autoimmune diseases and normal kidney function treated with IA therapy were recruited (Table 1). Concomitant immunosuppressive therapy was prednisolone (n ϭ 4), mycophenolate mofetil (n ϭ 3), and cyclosporine A (n ϭ 1); 3 patients received no additional therapy. We recruited additi...

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Increased proliferation of blood mononuclear cells after plasmapheresis treatment of patients with demyelinating disease

Cited by 31 publications

References 24 publications

Lymphocyte Subset Proportions in Guillain-Barré Syndrome Patients Treated with Plasmapheresis

Lymphocyte Subset Proportions in Guillain-Barré Syndrome Patients Treated with Plasmapheresis

Immune Mediated Diseases and Immune Modulation in the Neurocritical Care Unit

Influence of plasma immunoglobulin level on antibody synthesis

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