Therapeutic leukocytapheresis for inflammatory bowel disease

Saniabadi, Abbi R.; Hanai, Hiroyuki; Fukunaga, Ken; Sawada, Koji; Shima, Chieko; Bjarnason, Ingvar; Löfberg, Robert

doi:10.1016/j.transci.2007.08.003

Cited by 79 publications

(115 citation statements)

References 58 publications

Supporting

Mentioning

109

Contrasting

Unclassified

Order By: Relevance

“…It is filled with specially designed cellulose acetate beads of 2mm in diameter as the column leucocytapheresis carriers that are bathed in physiologic saline (50). The carriers remove from blood in the column most of the granulocytes, monocytes/macrophages together with some platelets (7,51). Surprisingly, the procedure has been associated with a sustained increase in absolute lymphocyte counts in the post treatment phase (32,33,50) including the regulatory phenotype, CD4(+)CD25(+) Treg (7,49,50).…”

Section: Therapeutic Leucocytapheresis In Ulcerative Colitis -Logics mentioning

confidence: 99%

See 1 more Smart Citation

The Diagnostic Value of Colonoscopy in Understanding Inflammatory Mucosal Damage in Patients with Ulcerative Colitis and Predicting Clinical Response to Adsorptive Leucocytapheresis as a Non-Pharmacologic Treatment Intervention

Saniabadi¹,

Suzuki²

2011

Endoscopic Procedures in Colon and Rectum

View full text Add to dashboard Cite

Endoscopic Procedures in Colon and Rectum 82by diverse environmental factors (2). From here on, we shall focus only on UC. The severity of UC is often presented by clinical activity index (CAI). Another, but complementary parameter is endoscopic activity index, not used in this chapter. Colonoscope, the gastroenterologist's eye and arms in modern timesColonoscopy is a revolutionary development in gastroenterology, now days like both arm and eyes for specialist gastroenterologists that can reach the inside of the large and distal segment of the small intestine. Introduced in the late 1960s (3), the term, colonoscopy refers to the endoscopic examination of the bowel with a charge-coupled device (CCD) camera or a fiber optic camera on a flexible tube passed through the rectal opening. As the name implies, colonoscopy allows a visual diagnosis of intestinal wall lesions like inflammation, ulceration, polyps and provides the opportunity for biopsy or removal of suspected cancerous lesions. Colonoscopy can remove polyps as small as one millimetre or less. Once polyps are removed, they can be studied with the aid of a microscope to determine if they are precancerous or not. Retrograde colonoscopy of the entire colon, and endoscopic excision of polyps from anywhere in the colon, began in 1969 (4). Momentous advances have occurred over the past two decades, and the two procedures are now widely accepted and practiced. Development and perfection of the methodology were, at first, fraught with many difficulties, both procedural and technical, which had to be overcome. Significant opposition was engendered in the early years by some who claimed that the methods were both unnecessary and unduly dangerous. Time has proven otherwise. Progress came about as the result of a steady stream of publications from a number of centres documenting the successful and safe application of the methodology. More advanced versions include virtual colonoscopy, which uses 2D and 3D imagery reconstructed from computed tomography (CT) scans or from nuclear magnetic resonance (MR) scans, is also possible, as a totally non-invasive medical test. However, unlike standard colonoscopy, virtual colonoscopy does not allow for therapeutic maneuvers such as polyp/tumour removal or biopsy nor visualization of lesions smaller than 5 millimeters. If a growth or polyp is detected by using CT colonography, a standard colonoscopy would still need to be performed. Further, colonoscopy is similar to, but not the same as, sigmoidoscopy, the difference being related to which parts of the colon each can examine. A colonoscopy allows an examination of the entire colon (measuring more than 1.5m in length). A sigmoidoscopy allows an examination of only the final 60cm of the colon. A sigmoidoscopy is often used as a screening procedure for a full colonoscopy to be followed in many instances in conjunction with a faecal occult blood test, which can detect the formation of cancerous cells throughout the colon. At other times, a sigmoidoscopy is preferred to a full colonos...

show abstract

Section: Therapeutic Leucocytapheresis In Ulcerative Colitis -Logics mentioning

confidence: 99%

“…The mechanisms for sparing lymphocytes are briefly described here. Patients with immune dysfunction may have immune complexes (IC) in their plasma (7,51,52). Cellulose acetate adsorbs immunoglobulin G (IgG) and IC from the plasma (52,53).…”

Section: Therapeutic Leucocytapheresis In Ulcerative Colitis -Logics mentioning

confidence: 99%

The Diagnostic Value of Colonoscopy in Understanding Inflammatory Mucosal Damage in Patients with Ulcerative Colitis and Predicting Clinical Response to Adsorptive Leucocytapheresis as a Non-Pharmacologic Treatment Intervention

Saniabadi¹,

Suzuki²

2011

Endoscopic Procedures in Colon and Rectum

View full text Add to dashboard Cite

show abstract

“…12 The duration of both LCA and GMA sessions was 60 minutes. Blood flow rates for LCA and GMA were 40 mL/min and 30 mL/min, respectively as used in previous studies.…”

Section: Induction Of Remission By Capmentioning

confidence: 99%

“…4,5 A new non-drug strategy introduced in recent years is cytapheresis (CAP) for the treatment of patients with active UC, including patients with severe refractory UC. [6][7][8][9][10][11][12] The primary action of CAP is to regulate the dysregulated immune response by removing inflammatory cytokine producing circulating leukocytes, especially granulocytes, which are destined for infiltration into the mucosa. 12 Currently, filtration leukocytapheresis (LCA), 7 and adsorptive granulocyte/monocyte apheresis (GMA) [8][9][10][11][12] are the two major CAP therapies for patients with an acute UC flare.…”

Section: Introductionmentioning

confidence: 99%

“…9,10 Impressive clinical efficacy has been reported by some of these studies (albeit mostly in uncontrolled studies). [6][7][8][9][10][11][12] GMA and LCA were approved by the Japan health insurance scheme for patients with active UC in 2000 and 2001, respectively. Over an 80,000 individuals have registered in the national UC database, and in 2006, approximately 30,000 CAP sessions were performed in Japan alone.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cytapheresis in Patients with Severe Ulcerative Colitis after Failure of Intravenous Corticosteroid: A Long-Term Retrospective Cohort Study

Fukunaga

Nagase²,

Kusaka³

et al. 2009

Gut Liver

Self Cite

View full text Add to dashboard Cite

Background/Aims: Cytapheresis (CAP) is a novel strategy for ulcerative colitis (UC). However, there is insufficient data on the long-term outcome of UC patients who achieve remission by CAP. This study involved patients with severe UC who refracted to intravenous (iv) corticosteroid. Methods: Forty-seven UC patients who had received CAP therapy for the first time within 1 year after UC diagnosis were followed for 36 months. One of the inclusion criteria was a clinical activity index (CAI) of ≥7 points at the end of a 2-week iv course of corticosteroid therapy. CAP therapy consisted of ten sessions over 10 weeks. Results: CAP induced clinical remission (CAI≤4) in 70.2% patients (33/47). The number of submissions for colectomy was higher for severe UC at entry (CAI≥12, n=25) than for moderately severe UC at entry (7≤CAI ＜12, p=15; p＜0.02). The cumulative rates of avoiding surgery and relapse were 54.5% and 24.2%, respectively, at 36 months in patients who responded to CAP therapy. This was similar to that of iv cyclosporine reported recently. Conclusions: This study suggest that CAP is an effective therapy in patients who are refractory to conventional medications including iv corticosteroid. Increased remission rates should be expected in refractory patients with moderately severe UC. (Gut and Liver 2009;3:41-47)

show abstract

Quantitive Cytokine mRNA Expression Profiles in the Colonic Mucosa of Patients with Steroid Naïve Ulcerative Colitis During Active and Quiescent Disease

Matsuda

Koide

Tokoro

et al. 2009

Inflammatory Bowel Diseases

View full text Add to dashboard Cite

show abstract

Therapeutic leukocytapheresis for inflammatory bowel disease

Cited by 79 publications

References 58 publications

The Diagnostic Value of Colonoscopy in Understanding Inflammatory Mucosal Damage in Patients with Ulcerative Colitis and Predicting Clinical Response to Adsorptive Leucocytapheresis as a Non-Pharmacologic Treatment Intervention

The Diagnostic Value of Colonoscopy in Understanding Inflammatory Mucosal Damage in Patients with Ulcerative Colitis and Predicting Clinical Response to Adsorptive Leucocytapheresis as a Non-Pharmacologic Treatment Intervention

Cytapheresis in Patients with Severe Ulcerative Colitis after Failure of Intravenous Corticosteroid: A Long-Term Retrospective Cohort Study

Quantitive Cytokine mRNA Expression Profiles in the Colonic Mucosa of Patients with Steroid Naïve Ulcerative Colitis During Active and Quiescent Disease

Contact Info

Product

Resources

About