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Granulocyte Apheresis in Inflammatory Bowel Disease: Possible Mechanisms of Effect

B.J. RembackenH.E. NewbouldS.J. RichardsS.A. MisbahM.E. DixonD.M. ChalmersA.T.R. Axon, https://doi.org/10.1111/j.1744-9987.1998.tb00082.x

We have studied the effects of granulocyte apheresis in 18 patients with ulcerative colitis and 6 with Crohn’s disease who had failed to respond to conventional therapy. Patients were treated with weekly apheresis using a granulocyte removal column (GI, Otsuka Pharmaceutical Co., Ltd., London, U.K.). We found a mean reduction in circulating granulocytes of 1.29 × 109 cells/L with no significant alterations in red blood cell monocyte, total lymphocyte, absolute T-helper, or T-cytotoxic lymphocyte counts. There were no significant changes in complement levels or immunoglobulin subclasses. There was a signifycant increase in granulocyte adhesion and a reduction in L-selectin expression. The removal of granulocytes is unlikely to explain the effect of granulocytapheresis. The markedly increased expression of αm integrin/Mac-1 and low L-selectin expression alter the capability of granulocytes to migrate to sites of inflammation and may be responsible for the improvement observed in patients treated with granulocyte apheresis.

Granulocyte Apheresis in Inflammatory Bowel Disease: Possible Mechanisms of Effect – Rembacken – 1998 – Therapeutic Apheresis – Wiley Online Library

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