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Removal Characteristics of Immunoadsorption with the Tryptophan‐Immobilized Column Using Conventional and Selective Plasma Separators in the Treatment of Myasthenia Gravis
Author(s) -
Ohkubo Atsushi,
Okado Tomokazu,
Sakurasawa Takatoshi,
Maeda Takuma,
Itagaki Ayako,
Yamamoto Hiroko,
Miyamoto Satoko,
Seshima Hiroshi,
Kurashima Naoki,
Mori Takayasu,
Iimori Soichiro,
Sohara Eisei,
Rai Tatemitsu,
Uchida Shinichi,
Naito Shotaro
Publication year - 2019
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 - 10.1111/1744-9987.12820
Subject(s) - immunoadsorption , medicine , myasthenia gravis , fibrinogen , autoantibody , rituximab , ldl apheresis , antibody , plasmapheresis , apheresis , chromatography , immunology , chemistry , platelet
Autoimmune neurological diseases are often treated by immunoadsorption using a conventional plasma separator and tryptophan‐immobilized column (IA). However, there is only one case report on treatment with immunoadsorption using a selective plasma separator and tryptophan‐immobilized column (SeIA) in clinical practice. This study aimed to investigate the removal characteristics of antibodies against acetylcholine receptors (AChRAb), immunoglobulin G, fibrinogen, and factor XIII (FXIII) in IA and SeIA in four patients with myasthenia gravis. A total of 19 sessions of immunoadsorption were performed (five sessions of IA and 14 sessions of SeIA) when the processed plasma volume was 2 L. The corresponding reductions were 52.5% ± 6.2% for AChRAb, 58.8% ± 4.2% for fibrinogen, and 36.9% ± 5.5% for FXIII after one session of IA. The corresponding reductions were 45.2% ± 9.9% for AChRAb, 3.5% ± 6.9% for fibrinogen, and −4.6% ± 11.1% for FXIII after one session of SeIA. The removal rates for AChRAb, fibrinogen, and FXIII in IA were significantly higher than those in SeIA. IA could effectively remove AChRAb, and SeIA could retain fibrinogen and FXIII. IA can be combined with SeIA, resulting in both IgG autoantibodies removal by IA and retention of coagulation factors by SeIA.