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Clinical Response Is Associated with Elevated PlasmaInterleukin-1 Receptor Antagonist During Selective Granulocyte and Monocyte Apheresis in Patients with Ulcerative Colitis

Kyoya Sakimura · Toshihide Omori · Etsuro Iwashita ·Takeshi Yoshida · Yoshikazu Tsuzuki · Kenji Fujimori ·Fumio Konishi · Yukio Yoshida · Hiroo Anzai ·Hiromichi Suzuki · Souichi Sugawara · Yuji Takeda ·Katsuya Hiraishi · Abbi R. Saniabadi · Tatsuo Ide ·Soichiro Miura · Shinichi Ota

Dig Dis Sci 2006 Sep;51(9):1525-31. doi: 10.1007/s10620-005-9012-1. Epub 2006 Aug 12.

Depletion of granulocytes and monocytes (GM) by selective apheresis (GMA) with an Adacolumn exerts
an anti-inflammatory effect in patients with ulcerative colitis (UC) or rheumatoid arthritis. However, the mechanism of the
anti-inflammatory effect of GMA is not fully understood yet. We investigated the effect of GMA on the plasma concentration of interleukin-1 receptor antagonist (IL-1ra), a potent anti-inflammatory cytokine. Twenty-six patients with active UC received GMA at one session per week for 5 consecutive weeks. Clinical response was defined as clinical activity index (CAI = CAI at entry – CAI at post) ≥ 4, while clinical remission was defined as CAI ≤ 4. Twenty-one of twenty-six patients (80.8%) responded to GMA. In the first session, plasma from responder patients showed a significant (P < 0.01) increase in IL-1ra in the Adacolumn outflow. In contrast, there was no change in IL-1ra in nonresponders. In conclusion, release of IL-1ra during GMA might be one mechanism of clinical efficacy associated with this therapy.

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