Removal of Thymic‐Derived Lymphocytes during Pheresis Procedures

Dwyer, John M.; Wade, Marcia J.; Katz, Amiram

doi:10.1111/j.1423-0410.1981.tb01051.x

Cited by 12 publications

(3 citation statements)

References 16 publications

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“…Generally, there is a decrease in the number of blood lymphocytes, but it is variable and affected by hemodilution. Pre-and postapheresis donor lymphocyte counts generally do not differ by more than 20% [8,19,201, but decreases as great as 38% [ ISJ and 57% IS] after apheresis have been reported. These decreases are transient and, apparently, cause no immunologic dysfunction.…”

Section: Significance Of Lymphocyte Lossesmentioning

confidence: 97%

Panel V: Cellular depletion by apheresis

Strauss

Huestis²,

Wright³

et al. 1983

J of Clinical Apheresis

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Section: Significance Of Lymphocyte Lossesmentioning

confidence: 97%

Panel V: Cellular depletion by apheresis

Strauss

Huestis²,

Wright³

et al. 1983

J of Clinical Apheresis

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“…First, this anti-coagulant combination has been shown to minimize complement activation during clinical LDL-apheresis [39,40]. Secondly, ACD-A decreases platelet and granulocyte aggregation [41].…”

Section: Discussionmentioning

confidence: 99%

Exploring the feasibility of selective depletion of T lymphocyte subsets by whole blood immunoadsorption cytapheresis

Belák¹,

Valeri

Wright³

2007

Clinical and Experimental Immunology

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SummaryNormal turnover of T lymphocytes is slow relative to other blood cells. Consequently, the physical removal of circulating leucocytes by thoracic duct drainage, repeated leukapheresis or blood filtration results in T cell depletion and immunosuppression. However, clinical use of such procedures is impractical compared with immunosuppressive drugs or radiation. None the less, immunosuppression by physical depletion of T cells, avoiding the systemic toxicities of drugs and radiation, might have clinical advantages if immunophenotypically distinct T cell subsets could be depleted selectively. Recent advances in targeted plasma protein apheresis using adsorbent macrobead columns prompted us to determine whether analogous techniques might permit CD4+ T lymphocytes to be removed selectively from whole blood. To explore this possibility, we linked murine anti-human-CD4 and isotypeidentical control monoclonal antibodies (mAbs) to agarose, polyacrylamide and polystyrene macrobeads (150-350 mm) and then evaluated the selectivity, specificity and efficiency of macrobead columns to remove CD4 + T cells from anti-coagulated whole blood at varying mAb densities and flow rates. We also examined saturation kinetics and Fc-oriention versus random coupling of mAbs to macrobeads. Sepharose 6MB macrobead (250-350 mm) columns proved to be most effective, selectively removing up to 98% of CD4 + T cells from whole blood. Moreover, depletion efficiency and selectivity were retained when these columns were reused after elution of adherent CD4 + cells. These studies indicate that selective depletion of T lymphocyte subsets by whole blood immunoadsorption apheresis using mAb-linked macrobead columns may be feasible on a clinical scale. It is possible that such apheresis techniques could achieve targeted forms of immunosuppression not possible with drugs or radiation.

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“…Hence, short courses of lymphocy tapheresis should be performed which do not greatly affect T lymphocyte levels, since their replacement in adult life appears to be inefficient [93].…”

Section: Plasma Substitutionmentioning

confidence: 99%

Plasma Exchange in Neurological Diseases

Valbonesi¹,

Garelli²

1983

Vox Sanguinis

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The rationale for and results of plasma exchange (PE) in the therapy of different immune-mediated neurological diseases such as myasthenia gravis, multiple sclerosis, acute and chronic-relapsing Guillain-Barré syndromes, polymyositis, dermatomyositis and amyothrophic lateral sclerosis are reviewed. Dialysis dementia and Refsum’s disease, subacute sclerosing panencephalitis and schizophrenia are mentioned, too. If we exclude the treatment of acute Guillain-Barré syndrome, where PE alone appears to be sufficient to produce recovery or improvement, the combined use of immunosuppressive drugs and/or lymphocytapheresis is probably needed in the treatment of the other diseases. PE allows the disease to be controlled rapidly while long-term pharmacological control is established. An underlying theme in this review is the need of adequately controlled studies or at least of large case lists with exhaustive reports concerning both positive and negative results since a new perspective is needed for this topic. Nonetheless, a number of uncontrolled observations suggest that probably PE effectiveness in most immune-mediated neurological diseases could be proven if the requisite trials were performed.

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Removal of Thymic‐Derived Lymphocytes during Pheresis Procedures

Cited by 12 publications

References 16 publications

Panel V: Cellular depletion by apheresis

Panel V: Cellular depletion by apheresis

Exploring the feasibility of selective depletion of T lymphocyte subsets by whole blood immunoadsorption cytapheresis

Plasma Exchange in Neurological Diseases

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