Use of granulocyte and monocyte adsorption apheresis in dermatology (Review)

Abstract

Adsorptive granulocyte and monocyte apheresis (GMA) is an extracorporeal treatment that selectively removes activated myeloid lineage leukocytes from peripheral blood. This technique consists of a column with cellulose acetate beads as absorptive leukocytapheresis carriers, and was initially used to treat ulcerative colitis. A literature search was conducted to extract recently published studies about the clinical efficacy of GMA in patients with different skin disorders, reporting information on demographics, clinical symptoms, treatment and clinical course. Dermatological diseases, in which GMA has been performed, include generalized pustular psoriasis, pyoderma gangrenosum, palmoplantar pustular psoriasis, Behcet's disease, Sweet's syndrome, adult-onset Still's disease, impetigo herpetiformis, reactive arthritis, acne and hidradenitis suppurativa syndrome, cutaneous allergic vasculitis and systemic lupus erythematosus. In most patients, GMA was started after the failure of conventional therapeutic options and it was helpful in the majority of cases. Based on the information summarized, GMA could be considered a valid non-pharmacological treatment option for patients with several dermatological conditions, which are difficult to treat with other pharmacological preparations.

Palbociclib blocks neutrophilic phosphatidylinositol 3‐kinase activity to alleviate psoriasiform dermatitis

“…Neutrophil depletion by specific antibody significantly alleviated psoriasiform dermatitis in imiquimod‐primed mice (Han et al, 2020; Sumida et al, 2014) and therapeutic depletion of neutrophils in patients with generalized pustular psoriasis also has been considered as a valid treatment option (Gnesotto et al, 2022; Ikeda et al, 2013). To date, pharmacologically targeting neutrophil activation and infiltration has been proved as a useful strategy for psoriasis treatment (C. Y. Chen, Lee, et al, 2019; Glennon‐Alty et al, 2018; Nemeth et al, 2020; Tsai et al, 2021).…”

Successful Use of Granulocyte and Monocyte Adsorptive Apheresis in a Patient with Post-COVID-19 Multisystem Inflammatory Syndrome in Adults

“…GMA was first clinically applied for ulcerative colitis, and its applications are expanding ( 13 , 14 ). GMA's mechanism of action is speculated to involve a shift of the inflammatory site from the patient's body to an extracorporeal column and the correction of the balance between inflammatory and anti-inflammatory cytokines ( 13 , 14 ). GMA removes approximately 65% of activated granulocytes and approximately 55% of monocytes/macrophages from the peripheral blood ( 15 , 16 ).…”

Role of neutrophil interleukin-23 in spondyloarthropathy spectrum disorders

“…It seems likely that some of the benefit of anti-IL-17A inhibition in psoriasis may relate to blocking neutrophil accumulation in the skin and thus pre-emptively disabling the amplification loop (86). Several open studies have also directly supported the value of granulocyte macrophage apheresis in both refractory psoriatic arthritis and psoriasis (87). The removal of both neutrophils and monocytes as IL-23 producers might be an important mechanism of action for these therapies.…”