A positive clinical experience of a long-term treatment pattern with leukocyte apheresis and Adacolumn in ulcerative proctitis.
Ulcerative proctitis (UP) is often involved in the diagnosis of inflammatory bowel disease (IBD). The increase of leukocytes and pro-inflammatory factors in peripheral blood and in the active forms, as well as the infiltration of neutrophils and monocytes/macrophages in the intestinal mucosa is known to occur in this entity. This infiltration of cells damages the mucosa due to the liberation of proteases, oxidation radicals and cytokines, among others. Apheresis techniques such as leukocyte apheresis may be used among the different therapeutic options such as steroids, sulfasalazine, 5-aminosalicylic, tacrolimus, azathioprine, cyclosporine, mycophenolate and biological agents.
Cytapheresis in patients with severe ulcerative colitis after failure of intravenous corticosteroid: a long-term retrospective cohort study
Ken Fukunaga 1, Kazuko Nagase, Takeshi Kusaka, Nobuyuki Hida, Yoshio Ohda, Koji Yoshida, Katsuyuki Tozawa, Koji Kamikozuru, M Iimuro, Shiro Nakamura, Hiroto Miwa, Takayuki Matsumoto, Gut Liver. 2009 Mar;3(1):41-7. doi: 10.5009/gnl.2009.3.1.41
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.
Down-regulation of interfeferon-γ parallels clinical response to selective leukocyte apheresis in patients with inflammatory bowel disease:a 12-month follow-up study
Leukocyte apheresis is a novel and safe nonpharmacological adjunct therapy that may prove useful in steroid refractory or dependent patients when conventional drugs have failed. Down-regulation of IFN-gamma in mucosal biopsies and in peripheral leukocytes may be a predictive marker for sustained, long-term response.
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