Scientific corner

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

Laura Gnesotto 1Guido Mioso 1Mauro Alaibac 1

Exp Ther Med 2022 Jun 24;24(2):536. doi: 10.3892/etm.2022.11463. eCollection 2022 Aug. DOI: 10.3892/etm.2022.11463

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.

 PASH syndrome; cutaneous allergic vasculitis; granulocyte and monocyte apheresis; neutrophilic dermatoses; reactive arthritis; systemic lupus erythematosus.

https://pubmed.ncbi.nlm.nih.gov/35837066/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9257973/

Scientific corner

Recommendations for Therapeutic Apheresis by the Section “Preparative and Therapeutic Hemapheresis” of the German Society for Transfusion Medicine and Immunohematology

Nina Worel 1Behrouz Mansouri Taleghani 2Erwin Strasser 3 Transfus Med Hemother 2019 Dec;46(6):394-406. doi: 10.1159/000503937. Epub 2019 Nov 6.

The section “Preparative and Therapeutic Hemapheresis” of the German Society for Transfusion Medicine and Immunohematology (DGTI) has reviewed the actual literature and updated techniques and indications for evidence-based use of therapeutic apheresis in human disease. The recommendations are mostly in line with the “Guidelines on the Use of Therapeutic Apheresis in Clinical Practice” published by the Writing Committee of the American Society for Apheresis (ASFA) and have been conducted by experts from the DACH (Germany, Austria, Switzerland) region.

https://pubmed.ncbi.nlm.nih.gov/31933569/

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6944925/

Scientific corner

P154 Clinical assessment of prognosis and the prognostic factors in intestinal Behcet’s disease

M HachiyaT SakuraiY NagataA HidakaY AkitaH MiyashitaY MaruyamaR MiyazakiM NoguchiR SawadaJ MitobeM MitsunagaT YamasakiT KatoM Saruta, Journal of Crohn’s and Colitis, Volume 12, Issue supplement_1, February 2018,

Approximately 30% of all cases and 50% of severe cases that had received biologics were not able to avoid surgery. In severe cases, it is important to evaluate early treatment efficacy and prognostic factors because the median time of administration of biologics was only 9 weeks. However, no independent prognostic factor was found in this study.

https://academic.oup.com/ecco-jcc/article/12/supplement_1/S173/4808214

Scientific corner

Updated treatment strategies for intestinal Behçet’s disease

Yong Eun Park 1Jae Hee Cheon 1 2 , Korean J Intern Med. 2018 Jan;33(1):1-19.

Recently, there has been a line of evidence suggesting that biologics such as infliximab and adalimumab are effective in treating intestinal BD. Moreover, new biologics targeting proteins other than tumor necrosis factor α are emerging and are under active investigation. Therefore, in this paper, we review the current therapeutic strategies and new clinical data for the treatment of intestinal BD.

https://pubmed.ncbi.nlm.nih.gov/29207867/

Scientific corner

Granulocyte and monocyte adsorption apheresis for Behçet’s disease in a pregnant woman.

Yuko Higashi 1Mitsuyoshi ShimokawaKazuhiro KawaiTakuro Kanekura, J Dermatol. 2013 Dec;40(12):1042-4.

We present a 39-year-old pregnant woman with Behçet’s disease who was treated successfully with granulocyte and monocyte adsorption apheresis (GMA). There were no complications or adverse effects during her pregnancy and delivery. The neonate manifested no abnormalities.

https://pubmed.ncbi.nlm.nih.gov/24303809/

Scientific corner

Adsorptive monocyte and granulocyte apheresis in the chronic inflammatory illness: ulcerous colitis, Crohn’s disease, rheumatoid arthritis and Behcet syndrome

J. Muñoz, M. Clavo, O. Garcia, D. Reina, A. Vidaller, R. Lafuente & L. I. Massuet

ISBT Science Series (2007) 2, 96–101

There is a strong basis to support the modulators properties of innate immunity of GCAP, although there is a lack of data that explains deeply the interactions between the mechanisms involved. GMA may represent a new therapy that offers not a single pathway effect but a global modulation of the most important pathways involved in innate immune response. Future investigations should elucidate the intimate mechanism of action.

https://www.researchgate.net/publication/239319651_Adsorptive_monocyte_and_granulocyte_apheresis_in_the_chronic_inflammatory_illness_ulcerous_colitis_Crohn’s_disease_rheumatoid_arthritis_and_Behcet_syndrome

Scientific corner

Granulocytapheresis in patients with refractory ocular Behcet’s disease

Kenichi Namba 1Koh-Hei SonodaHirokuni KitameiKenji ShiratoriAkiko AriyamaKazuya IwabuchiKazunori OnoéAbby R SaniabadiShoichi InabaTatsuro IshibashiShigeaki Ohno, J Clin Apher. 2006 Jul;21(2):121-8

We conclude that granulocytapheresis might be effective and safe for patients with refractory ocular BD. Further studies are necessary to fully evaluate the clinical efficacy of granulocytapheresis for BD.

https://pubmed.ncbi.nlm.nih.gov/16395727/

Scientific corner

Therapeutic neutrophil apheresis in patients with ocular Behcet disease

Scientific corner

Treatment of Behçet’s disease with granulocyte and monocyte adsorption apheresis

Takuro Kanekura 1Akira GushiMasahiro IwataSeita FukumaruRyoko SakamotoKoichi KawaharaIkuro MaruyamaTamotsu Kanzaki

J Am Acad Dermatol. 2004 Aug;51(2 Suppl):S83-7. doi: 10.1016/j.jaad.2003.12.023.

The painful orogenital ulcerations of Behçet’s disease are among the major symptoms of patients and are often intractable. We assessed the efficacy of granulocyte and monocyte adsorption apheresis therapy in two patients, a 21-year-old man with orogenital ulcerations and a 50-year-old woman with genital ulceration and abdominal pain. They underwent 5 and 8 granulocyte and monocyte adsorption apheresis treatments at 5-day intervals, respectively. The painful orogenital ulcerations of the man responded dramatically and the genital ulcer of the woman decreased in size and her abdominal pain was improved. Our results demonstrate that granulocyte and monocyte adsorption apheresis may be useful for treating orogenital ulcerations of Behçet’s disease.

https://pubmed.ncbi.nlm.nih.gov/15280820/

Contact UsFor more information

Contact Us