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Removal Kinetics of Antibodies Against Glutamic Acid Decarboxylase by Various Plasmapheresis Modalities in the Treatment of Neurological Disorders
Author(s) -
Ohkubo Atsushi,
Okado Tomokazu,
Kurashima Naoki,
Maeda Takuma,
Miyamoto Satoko,
Nakamura Ayako,
Seshima Hiroshi,
Iimori Soichiro,
Sohara Eisei,
Uchida Shinichi,
Rai Tatemitsu
Publication year - 2014
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12209
Subject(s) - plasmapheresis , immunoadsorption , medicine , glutamate decarboxylase , antibody , kinetics , treatment modality , fibrinogen , gastroenterology , immunology , biochemistry , chemistry , enzyme , physics , quantum mechanics
Plasmapheresis is one of the acute treatment modalities for neurological disorders associated with antibodies against glutamic acid decarboxylase (anti‐ GAD ). However, there is little information about the removal kinetics of anti‐ GAD by various plasmapheresis modalities. Here, we investigated the removal rate of anti‐ GAD and fibrinogen ( F ib) by immunoadsorption ( IA ), plasma exchange using a conventional plasma separator ( OP‐PE ), and plasma exchange using a high cut‐off selective membrane plasma separator ( EC‐PE ) in two cases of anti‐ GAD ‐associated neurological diseases. In case 1, IA and OP‐PE were used, and the percent reductions were as follows: anti‐ GAD : 38.2% and 69.1% and F ib: 67.7% and 68.2%, respectively. In case 2, OP‐PE and EC‐PE were used, and the percent reductions were as follows: anti‐ GAD : 65.8% and 48.5% and F ib: 68.5% and 19.8%, respectively. OP‐PE could remove anti‐ GAD more efficiently than IA . Further, EC‐PE could maintain coagulation factors such as F ib better than IA and OP‐PE . It is important to select the appropriate plasmapheresis modality on the basis of the removal kinetics.