Treatment of pustular psoriasis with granulocyte and monocyte adsorption apheresis

Kanekura, Takuro; Yoshii, Noriko; Yonezawa, Tomokazu; Kawabata, Hideyuki; Saruwatari, Hiroshi; Kanzaki, Tamotsu

doi:10.1067/s0190-9622(03)00795-3

Cited by 38 publications

(55 citation statements)

References 7 publications

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“…The same procedure, applied to a series of 4 patients with psoriatic arthritis (2 with PV and 2 with PP), resulted in remarkable clearing of joint pain, while the skin lesions improved only in the 2 patients with PP. Our results on the PV skin lesions picture are very different from those reported using GCAP [14,15].…”

Section: Discussioncontrasting

confidence: 85%

“…Photopheresis produced some measurable effects in psoriatic arthritis, but incomplete and conflicting results on skin lesions in small groups of patients [9][10][11][12][13]. Recently, granulocyte and monocyte adsorption apheresis (GCAP) produced interesting results in pustular psoriasis (PP) and in psoriatic arthritis, but not in PV [14,15].…”

Section: Introductionmentioning

confidence: 97%

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Lymphocytapheresis in the treatment of psoriasis vulgaris

et al. 2006

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Psoriasis is a common autoimmune chronic inflammatory skin disease that affects approximately 2% of the world's population; fundamental for its immunopathogenic mechanism is secretion of type 1 (Th1) cytokines by T cells and their activation. Since cytapheresis has been widely applied to autoimmune disorders, emphasizing the recently reported results of granulocyte and monocyte adsorption apheresis in psoriasis, a small series of psoriasis vulgaris (PV) patients underwent lymphocytapheresis (LCA) with the aim to remove lymphocytes. Five patients were submitted to weekly LCA. The severity of the disease had been evaluated through psoriasis area and severity index (PASI) score before LCA and one week after the last apheresis. PASI score before: patient A: 66; patient B: 33; patient C: 50; patient D: 56; patient E: 29. All the patients showed improvement of skin lesions. PASI score after LCA: patient A: 24; patient B: 8; patient C: 5; patient D: 36; patient E: 2.1. No side effects linked to apheresis were reported. LCA seems to produce interesting results in PV, and PASI improvement related to apheresis is clinically significant. Further studies to address its mechanism of action and potential long-term side effects are needed. It could become a valuable therapeutic alternative or a complementary tool, which might even be used to reduce the dosages of conventional pharmacological therapies adopted for this chronic disease.

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Section: Discussioncontrasting

confidence: 85%

Section: Introductionmentioning

confidence: 97%

Lymphocytapheresis in the treatment of psoriasis vulgaris

et al. 2006

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“…It is interesting to know that pyoderma and psoriasis-like skin lesions are reported to be the best responders to Adacolumn GMA [64][65][66]. Every treated case appears to have responded, yet this seems to have occurred by chance.…”

Section: Pyoderma Gangrenosum and Psoriasismentioning

confidence: 99%

The mode of actions of the Adacolumn therapeutic leucocytapheresis in patients with inflammatory bowel disease: a concise review

Hanai

Takeda

Eberhardson

et al. 2010

Clinical and Experimental Immunology

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SummaryPatients with active inflammatory bowel disease (IBD) have elevated and activated myeloid leucocytes which infiltrate the colonic mucosa in vast numbers. Myeloid leucocytes such as the CD14 + CD16 + monocytes are major sources of tumour necrosis factor (TNF)-a, and therefore selective granulocyte/monocyte (GM) adsorption (GMA) should promote remission or enhance efficacy of pharmacological therapy. However, studies in IBD have reported both impressive as well as disappointing efficacy outcomes, indicating that patients' demographic factors might determine responders or nonresponders to GMA. Nonetheless, this non-drug intervention has an excellent safety profile, and therapeutic GMA is expected to expand. In this review, attempts have been made to compile an update on the mode of actions (MoA) of the Adacolumn GMA. The MoA of GMA appears to be more than adsorption of excess neutrophils and TNF-producing CD14 + CD16 + monocytes per se. Adsorbed GMs release interleukin (IL)-1 receptor antagonist, hepatocyte growth factor and soluble TNF receptors, which are anti-inflammatory. Additionally, a sustained increase in lymphocytes including the regulatory CD4 + CD25 + T cells (lymphocyte sparing) is seen post-GMA. The impact of GMA on the immune system is potentially very interesting in the context of treating immune-related diseases. Future studies are expected to add intriguing insights to the MoA of GMA.

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“…[5][6][7][8] Aphaeresis techniques have been used in the treatment of some refractory autoimmune disorders such as myasthenia gravis, psoriasis, rheumatoid arthritis, or systemic lupus erythematosis. [9][10][11][12] These techniques allow the removal of immune cells or inflammatory mediators from the bloodstream. Granulocyteaphaeresis (GCAP) is an aphaeresis procedure that has been used for the treatment of IBD [mainly ulcerative colitis (UC)] in the last few years in Japan.…”

Section: Introductionmentioning

confidence: 99%

Granulocyteaphaeresis in steroid‐dependent inflammatory bowel disease: a prospective, open, pilot study

Domènech

Hinojosa

Esteve

et al. 2004

Aliment Pharmacol Ther

102

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Summary Background : Uncontrolled studies suggest that granulocyteaphaeresis might be useful in the management of active ulcerative colitis. Aim : To assess the efficacy of granulocyteaphaeresis treatment in active steroid‐dependent inflammatory bowel disease. Methods : We conducted a multicentre, prospective, open, pilot study in patients with steroid‐dependent inflammatory bowel disease. All patients were started on 60 mg/day of prednisone; after 1 week, a five‐session programme of granulocyteaphaeresis (once per week) was started. The steroid dose was tapered weekly if there was clinical improvement. Remission was defined as an inactive clinical activity index together with complete withdrawal of steroids at week 6. The patients were followed up for at least 6 months or until disease relapse. Results : Twenty‐six patients (14 ulcerative colitis, 12 Crohn's disease) were included. More than a half had been previously treated with immunomodulators. Remission was achieved in 62 and 70% of ulcerative colitis and Crohn's disease, respectively. During a median follow‐up of 12.6 months, six of eight ulcerative colitis patients maintained their clinical remission; however, only one Crohn's disease patient remained in remission after the first 6 months of follow‐up. Conclusions : Granulocyteaphaeresis is a safe treatment option in inflammatory bowel disease. A five‐session programme of granulocyteaphaeresis seems to be efficient in the treatment of steroid‐dependent ulcerative colitis, but not in Crohn's disease.

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Treatment of pustular psoriasis with granulocyte and monocyte adsorption apheresis

Cited by 38 publications

References 7 publications

Lymphocytapheresis in the treatment of psoriasis vulgaris

Lymphocytapheresis in the treatment of psoriasis vulgaris

The mode of actions of the Adacolumn therapeutic leucocytapheresis in patients with inflammatory bowel disease: a concise review

Granulocyteaphaeresis in steroid‐dependent inflammatory bowel disease: a prospective, open, pilot study

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