Scientific corner

Adacolumn therapeutic leucocytapheresis for ulcerative colitis: clinical and endoscopic features of responders and nonresponders to this nonpharmacologic intervention.

H. Hanai, Y. Takeda, M. Eberhardson, R. Gruber, A. R. Saniabadi, O. Winqvist and R. Lofberg, doi:10.1111/j.1365-2249.2010.04279.x

imflammatory cytokines include activated myeloid leucocytes, which in patients with IBD are elevated with activation behaviour,selective depletion of these proinflammatory leucocytes by GMA appears to be an attractive strategy to alleviate inflamamation or enhance the efficacy of pharmacological therapy. However, clinical studies have hitherto reported both impressive as well as disappointing efficacy outcomes, indicating that patients’ demographic factors might determine
responders or non-responders to GMA. Further, as this non drug-based treatment intervention has an excellent safety
profile, it is very much favoured by patients and our impression is that the use of therapeutic GMA will expand rather than diminish. The MoA of GMA appears to be more than physical depletion of excess and activated GM per se; the release of IL-1ra, HGF, sTNF RI, RII and the rise of regulatory CD4+ CD25+ T cells are typical effects which are potentially very interesting in the context of treating conditions that reflect a dysregulated immune profile

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