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The use of plasmapheresis, lymphocytapheresis, and staph protein‐A immunoadsorption as an immunomodulatory therapy in patients with aids and aids‐related conditions
Author(s) -
Kiprov Dobri D.,
Lippert Randolph,
Miller Robert G.,
Sandstrom Erik,
Jones Frank R.,
Cohen Richard J.,
Abrams Donald,
Busch David F.
Publication year - 1986
Publication title -
journal of clinical apheresis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.697
H-Index - 46
eISSN - 1098-1101
pISSN - 0733-2459
DOI - 10.1002/jca.2920030211
Subject(s) - medicine , plasmapheresis , immunoadsorption , immunology , peripheral neuropathy , sarcoma , immunopathology , immunosuppression , immune system , antibody , pathology , diabetes mellitus , endocrinology
Circulating immune complexes, autoantibodies, and suppressor factors to normal lymphoproliferation may play an important role in the induction and maintenance of the cellular immunodeficiency characteristic for the acquired immunodeficiency syndrome (AIDS) and its related conditions. In order to explore the possiblity that the removal of circulating humoral factors may have an immunomodulatory effect in patients with AIDS and AIDS‐related conditions (ARC), we used apheresis procedures to treat patients with different clinical presentations of AIDS and ARC. Five patients with AIDS and opportunistic infections were treated with plasmapheresis. Four patients with AIDS and Kaposi's sarcoma without opportunistic infections were treated with staph protein‐A immunoadsorption and two patients with ARC and peripheral neuropathy were treated with lymphoplasmapheresis. The treatments were tolerated well by all patients. Effective removal of circulating humoral immune factors was observed in all three groups. No significant clinical benefit was seen in the patients with AIDS and opportunistic infections treated with plasmapheresis. Partial tumor responses were observed in three of the four patients with AIDS related Kaposi's sarcoma treated with staph protein‐A plasma perfusion, and resolution of neurologic symptoms was seen in both patients with ARC and peripheral neuropathy treated with lymphoplasmapheresis. Our preliminary results suggest that lymphoplasmapheresis may be an effective treatment modality for patients with ARC related peripheral neuropathy, that protein‐A immunoadsorption is well tolerated by patients with AIDS‐related Kaposi's sarcoma, and that this treatment has antitumor and immunomodulatory effects in these patients.