Kento Fujii 1, Tomoko Takahashi 1, Kanako Matsuyama 1, Asami Fujii 1, Yoko Mizutani 1, Hidenori Ohnishi 2, Mariko Seishima 1 , J Dermatol 2020 Mar;47(3):e84-e85.
Tag: Dermatology
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Impetigo herpetiformis with a CARD14 Thr79Ile variant successfully treated with granulocyte and monocyte adsorption apheresis
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Pyoderma gangrenosum associated with ulcerative colitis: A recalcitrant case responded to adalimumab with granulocyte and monocyte adsorption apheresis
J Dermatol. 2020 May;47(5):e213-e215. doi: 10.1111/1346-8138.15303. Epub 2020 Mar 11.
letter.
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EO5-01 A case of pustular psoriasis deteriorated during the second pregnancy was successfully treated with intensive GMA and certolizumab pegol
Asumi Fujii, Yuki Hattori, Miho Kawamura, Yoko Mizutani, En Shu, Mariko Seishima
poster at ISFA 2019 pag 141-142
A 31-year-old woman with the IL36RN gene mutation developed psoriasis at 3 years old. As she had pustular psoriasis at 16 years old, she was treated with cyclosporine (Cys), resulting in remission at 20 years old. Afterwards, she had been maintained by topical treatment for long years.During the first pregnancy at the age of 29, she developed pustular psoriasis at 29 weeks
of gestation. She received one course of granulocyte / monocyte adsorption apheresis (GMA) with Cys and prednisolone (PSL), and gave birth to a girl at 33 weeks of gestation. The baby was a low birth weight child, but is healthy and has no problems in growth and development until now. However, the patient did not sufficiently improve symptoms after delivery. We thus started the treatment with infliximab (IFX) BS at 2 months postpartum. During the second pregnancy at the age of 30, we continued the IFX-BS administration. She had erythema and pustules rapidly enlarged from 23 weeks of pregnancy. Oral administration of PSL and GMA were started. However, we switched the therapy to intensive GMA (twice in a week), because the effect was insufficient. Initially, administration of IFX-BS was scheduled to end at 30 weeks of gestation, but due to unstable symptoms, we considered it was necessary to use another biologics even after 30 weeks of gestation. We switched to non-placental certolizumab pegol (CTZ) from 26 weeks of gestation and continued the administration until delivery, and she gave birth to a girl at 35 weeks of gestation. Although the baby was a low birth weight child, there was no physical abnormality and the baby was discharged after gaining weight. After delivery, administration of CTZ was discontinued and the PSL dose was gradually reduced. However,reintroduction of biologics is under consideration, because erythema and pustules still remain.
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SA6-03 MicroRNA and granulocyte and monocyte adsorption apheresis on neutrophilic skin diseases
Yuko Higashi, Munekazu Yamakuchi, Takuro Kanekura
poster at ISFA 2019 pag 126
Neutrophilic skin diseases are a group of disorders characterized by intense dermal infiltration of neutrophils without infection. They include a variety of diseases, such as pyoderma gangrenosum, pustular psoriasis, and palmoplantar pustulosis. We demonstrated that granulocyte and monocyte adsorption apheresis (GMA) is a useful treatment modality for such refractory skin diseases. Microarray analysis of microRNAs (miRNAs) was performed using sera of patients with neutrophilic skin diseases before and after GMA. Several miRNAs significantly increased in patients compared to control subjects. The expression of three
miRNAs decreased after apheresis, suggesting that these miRNAs might be involved in the pathogenesis of neutrophilic skin decreases. To prove the function of these miRNAs, HL-60, a human acute promyelocytic leukemia cell line, was differentiated by the treatment of alltrans retinoic acid (ATRA). When HL-60 was differentiated to neutrophilic cells, the HEstaining shows an increased cytoplasm to nucleus ratio, condensated chromatin, and nuclear segmentation. The expression of three miRNAs increased during the neutrophilic differentiation. Stimulation of ATRA-treated HL-60 by some cytokines altered miRNA expressions. Moreover, manipulation of these miRNAs changed proliferation of cultured keratinocytes. These data
suggest that miRNAs play an important role in regulating neutrophilic differentiation and proliferation of keratinocytes in case of neutrophilic disorders such as psoriasis. These miRNAs could be markers of disease severity and response of GMA.
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Evaluation of the efficacy of granulocyte and monocyte adsorption apheresis on skin manifestation and joint symptoms of patients with pustulotic arthro-osteitis
Hiroshi Kawakami 1, Yume Nagaoka 2, Hirofumi Hirano 1, Yuka Matsumoto 1, Namiko Abe 1, Ryoji Tsuboi 1, Yoshihiko Kanno 2, Yukari Okubo 1 J Dermatol 2019 Feb;46(2):144-148.
We concluded that granulocyte and monocyte adsorption apheresis is a therapeutic option to consider when pustulotic arthro-osteitis is recalcitrant to conventional therapy.
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Japanese guidelines for the management and treatment of generalized pustular psoriasis: The new pathogenesis and treatment of GPP.
Hideki Fujita 1, Tadashi Terui 1, Koremasa Hayama 1, Masashi Akiyama 2, Shigaku Ikeda 3, Tomotaka Mabuchi 4, Akira Ozawa 4, Takuro Kanekura 5, Michiko Kurosawa 6, Mayumi Komine 7, Kimiko Nakajima 8, Shigetoshi Sano 8, Osamu Nemoto 9, Masahiko Muto 10, Yasutomo Imai 11, Kiyofumi Yamanishi 11, Yumi Aoyama 12, Keiji Iwatsuki 13, J Dermatol . 2018 Nov;45(11):1235-1270.
The aim of the guidelines was to provide current information to aid in the treatment of patients with GPP in Japan. Its contents include the diagnostic and severity classification criteria for GPP, its pathogenesis, and recommendations for the treatment of GPP.
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Clinical and immunological effects of adsorptive myeloid lineage leukocyte apheresis in patients with immune disorders.
Takuro Kanekura 1, J Dermatol 2018 Aug;45(8):943-950
These actions render GMA a unique non-pharmacological treatment option for patients with chronic dermatoid conditions, which are difficult to treat with pharmacological preparations.
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Efficacy of cytapheresis for remission induction and dermatological manifestations of ulcerative colitis.
Osamu Nomura 1, Taro Osada 1, Tomoyoshi Shibuya 1, Dai Ishikawa 1, Keiichi Haga 1, Tomohiro Kodani 1, Naoto Sakamoto 1, Tatsuo Ogihara 1, Ken Yamaji 2, Sumio Watanabe 1 , J Clin Apher 2018 Feb;33(1):21-28.
In this retrospective efficacy evaluation, cytapheresis was effective as remission induction therapy with steroid sparing effect and desirable safety profile. Further, patients with EN or PG responded favorably to cytapheresis.
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Granulocyte and monocyte adsorption apheresis for palmoplantar pustulosis with extra-palmoplantar lesions and pustulotic arthro-osteitis.
Akiko Arimura 1, Kazuyasu Fujii 1, Atsuko Ibusuki 1, Miho Hatanaka 1, Masanao Sakanoue 1, Yuko Higashi 1, Takuro Kanekura 1 , J Dermatol 2018 Jun;45(6):e167-e168.
Combination of GMA and anti-tumor necrosis factor is a safe and effective treatment after the loss of response to these biologic agents, with a significant decrease of the clinical disease activity and biomarkers, in a population with limited therapeutic alternatives.
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Granulocyte/Monocyte Adsorption Apheresis as a Novel Therapeutic Approach in the Treatment of an Impetigo Herpetiformis Case.
Aya Iwasaki 1, Hiroshi Kawakami 1, Yukari Okubo 1 , Ther Apher Dial. 2018 Aug;22(4):414-416.
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