Looking for predictive factors of clinical response to adsorptive granulocyte and monocyte apheresis in patients with ulcerative colitis: markers of response to GMA

Yokoyama, Yoko; Kawai, Mikio; Fukunaga, Ken; Kamikozuru, Koji; Nagase, Kazuko; Nogami, Koji; Kono, Tomoaki; Ohda, Yoshio; Iimuro, Masaki; Hida, Nobuyuki; Nakamura, Shirô; Miwa, Hiroto; Matsumoto, Takayuki

doi:10.1186/1471-230x-13-27

Cited by 32 publications

(42 citation statements)

References 38 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Hibi et al reported that higher baseline granulocyte fraction was an independent predictor of clinical response in GMA [18]. Low cumulative prednisolone doses, receiving GMA immediately after a clinical relapse, low WBC count at the first GMA session, and younger age were also reported as responders [26,27]. Our study also showed younger patients were responders.…”

Section: Discussionsupporting

confidence: 65%

“…Previous studies have shown that patients with a short duration of UC appeared to respond well to GMA [24,25,26]. Hibi et al reported that higher baseline granulocyte fraction was an independent predictor of clinical response in GMA [18].…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies have shown that patients with a short duration of UC, higher baseline granulocyte fraction, younger age, and steroid naïveté appeared to respond well to GMA [18,22,23,24,25,26,27]. Although these factors are useful for deciding whether to introduce GMA treatment or not, there are no indicators that detect responders at an early phase after starting GMA treatment.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

et al. 2015

View full text Add to dashboard Cite

Background: Fecal lactoferrin has been introduced as a useful tool for the diagnosis and monitoring of inflammatory bowel disease (IBD). The aim of this study was to assess if fecal lactoferrin can be employed to predict or estimate the effect of granulocyte and monocyte adsorptive apheresis (GMA) in ulcerative colitis (UC). Methods: This was a prospective study involving 21 patients with UC. Patients with moderately-to-severely active UC who were scheduled to undergo GMA were recruited. Changes in fecal lactoferrin concentration were compared between the GMA-responder and -nonresponder groups. Results: In the GMA-responder group, fecal lactoferrin significantly increased 1 week after the introduction of GMA and then significantly decreased after GMA sessions. Fecal lactoferrin concentrations were significantly higher in the GMA-responder group than in the GMA-nonresponder group at 1 and 2 weeks after the introduction of GMA. Multivariate logistic regression analysis revealed that fecal lactoferrin concentration 1 week after the introduction of GMA was the most contributing factor for the effectiveness of GMA in patients with UC. Conclusions: In the GMA-responder group, fecal lactoferrin concentration significantly increased 1 week after the introduction of GMA. Fecal lactoferrin may be beneficial for predicting clinical response of GMA in patients with UC at an early stage of GMA treatment.

show abstract

Section: Discussionsupporting

confidence: 65%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

et al. 2015

View full text Add to dashboard Cite

show abstract

“…All patients received GMA therapy twice a week with the Adacolumn as previously described 12,17. The first patient evaluation was done after six GMA sessions.…”

Section: Methodsmentioning

confidence: 99%

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Liu

Yao

et al. 2017

Gut and Liver

View full text Add to dashboard Cite

Background/AimsPatients with active ulcerative colitis (UC) have elevated levels of activated myeloid-derived leukocytes as a source of inflammatory cytokines. The selective depletion of these leukocytes by adsorptive granulocyte/monocyte apheresis (GMA) with an Adacolumn should alleviate inflammation, promote remission and enhance drug efficacy. However, studies have reported contrasting efficacy outcomes based on patients’ baseline demographic variables. This study was undertaken to understand the demographic features of GMA responders and nonresponders.MethodsThis was a multicenter study in China involving four institutions and 34 patients with active UC. Baseline conventional medications were continued without changing the dosage. The treatment efficacy was evaluated based on the endoscopic activity index and the Mayo score.ResultsThirty of the 34 patients completed all 10 GMA treatment sessions. The overall efficacy rate was 70.59%. The receiver operating characteristic analysis showed that the area under the curve was approximately 0.766 for a Mayo score of ≤5.5 with 0.273 specificity and 0.857 sensitivity (Youden index, 0.584) for GMA responders. No GMA-related serious adverse events were observed.ConclusionsThe overall efficacy of GMA in patients with active UC who were taking first-line medications or were corticosteroid refractory was encouraging. Additionally, GMA was well tolerated and had a good safety profile.

show abstract

“…The best responders seem to be steroid naive patients followed by steroid dependent patients or steroid refractory patients with a short history of disease [152,153] . A recent study tried to define predictive factors to identify patients with UC who are likely to respond to GMA [154] . In this trial 43 patients with active UC were enrolled.…”

Section: Granulocyte Monocyte Apheresismentioning

confidence: 99%

Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults

Leitner

Vogelsang

2016

WJGPT

View full text Add to dashboard Cite

Inflammatory bowel diseases (IBDs) are a group of chronic inflammatory conditions mainly of the colon and small intestine. Crohn's disease (CD) and ulcerative colitis (UC) are the most frequent types of IBD. IBD is a complex disease which arises as a result of the interaction of environmental, genetic and immunological factors. It is increasingly thought that alterations of immunological reactions of the patients to their own enterable bacteria (microfilm) may contribute to inflammation. It is characterized by mucosal and sub mucosal inflammation, perpetuated by infiltration of activated leukocytes. CD may affect the whole gastrointestinal tract while UC only attacks the large intestine. The therapeutic goal is to achieve a steroidfree long lasting remission in both entities. UC has the possibility to be cured by a total colectomy, while CD never can be cured by any operation. A lifelong intake of drugs is mostly necessary and essential. Medical treatment of IBD has to be individualized to each patient and usually starts with anti-inflammatory drugs. The choice what kind of drugs and what route administered (oral, rectal, intravenous) depends on factors including the type, the localization, and severity of the patient's disease. IBD may require immune-suppression to control symptoms such as prednisolone, thiopurines, calcineurin or sometimes folic acid inhibitors or biologics like TNF-α inhibitors or anti-integrin antibodies. For both types of disease (CD, UC) the same drugs are available but they differ in their preference in efficacy between CD and UC as 5-aminosalicylic acid for UC or budesonide for ileocecal CD. As therapeutic alternative the main mediators of the disease, namely the activated pro-inflammatory cytokine producing leukocytes can be selectively removed via two apheresis systems (Adacolumn and Cellsorba) in steroid-refractory or dependent cases. Extracorporeal photopheresis results in an increase of regulatory B cells, regulatory CD8 + T cells and T-regs Type 1. Both types of apheresis were able to induce clinical remission and mucosal healing accompanied by tapering of steroids.

show abstract

Looking for predictive factors of clinical response to adsorptive granulocyte and monocyte apheresis in patients with ulcerative colitis: markers of response to GMA

Cited by 32 publications

References 38 publications

Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

Advantages of Fecal Lactoferrin Measurement during Granulocyte and Monocyte Adsorptive Apheresis Therapy in Ulcerative Colitis

Adsorptive Granulocyte and Monocyte Apheresis in the Treatment of Ulcerative Colitis: The First Multicenter Study in China

Pharmacological- and non-pharmacological therapeutic approaches in inflammatory bowel disease in adults

Contact Info

Product

Resources

About