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Specificity of antibody responses affected by extracorporeal immunoadsorption of plasma over columns of protein A silica
Author(s) -
Snyder Harry W.,
Seawell Betty W.,
Cochran Sharon K.,
Balint Joseph P.,
Jones Frank R.
Publication year - 1992
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.2920070303
Subject(s) - immunoadsorption , medicine , antibody , autoantibody , antigen , thrombocytopenic purpura , platelet , immunology , thrombotic thrombocytopenic purpura , plasmapheresis , immune system
A relationship is described between the interaction of circulating immune complexes (CIC) from plasma with staphylococcal protein A immunoadsorption treatment columns and modulation of antibody responses related to the specific CIC. Eluates from the initial immunoadsorption columns used to treat a series of patients with breast adenocarcinoma, cancer chemotherapy‐associated thrombotic thrombocytopenic purpura/hemolytic uremic syndrome (C‐TTP/HUS), or immune thrombocytopenic purpura (ITP) were evaluated for disease‐specific CIC containing Le x glycosphingolipid (Le x gl) adenocarcinoma‐associated antigens or platelet autoantibody (anti‐GPIIb/IIIa), together with the corresponding neutralizing antibody [anti‐F(ab′) 2 ], and for nonspecific CIC containing cytomegalovirus (CMV) or herpes simplex virus type 1 (HSV‐1) antigens. In addition, the levels of antibodies directed against CMV, HSV‐1. Le x gl, and GPIIb/IIIa antigens, as well as anti‐F(ab′) 2 antibodies, were compared in pretreatment and posttreatment serum samples. Columns used to treat breast adenocarcinoma patients contained only Le x gl CIC, and the only immunologic change observed after treatment was significant increases in anti‐Le x gl antibodies in some patients. Columns used to treat C‐TTP/HUS patients contained anti‐GPIIb/IIIa‐anti‐F(ab′) 2 CIC, in addition to Le x gl CIC. After treatment, significant increases in anti‐Le x gl and anti‐F(ab′) 2 antibodies and significant decreases in anti‐GPIIb/IIIa antibodies were observed in some patients. Columns used to treat ITP patients only exhibited anti‐GPIIb/IIIa‐anti‐F(ab′) 2 CIC, and after treatment only decreases in anti‐GPIIb/IIIa and increases in anti‐F(ab′) 2 antibodies were observed in some patients. None of the treatment columns exhibited CIC with CMV or HSV‐1 antigens, and no effects on pretreatment levels of anti‐CMV or anti‐HSV‐1 antibodies were observed in any patients posttreatment. Immunologic responses were correlated closely with clinical responses in each group of patients. The study showed that neither stimulation nor depression of antibody responses occurred in the absence of an interaction of corresponding specific CIC with the matrix. The results suggest that nonspecific stimulation of a variety of antibody responses is not the usual mechanism by which clinical responses to protein A immunoadsorption treatment are obtained. © 1992 Wiley‐Liss, Inc.