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Granulocytapheresis in the Treatment of Patients with Rheumatoid Arthritis
Author(s) -
Ohara Morihiro,
Saniabadi Abby R.,
Kokuma Seiichiro,
Hirata Ichiro,
Adachi Masakazu,
Agishi Tetsuzo,
Kasukawa Reiji
Publication year - 1997
Publication title -
artificial organs
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.684
H-Index - 76
eISSN - 1525-1594
pISSN - 0160-564X
DOI - 10.1111/j.1525-1594.1997.tb00513.x
Subject(s) - apheresis , rheumatoid arthritis , medicine , exacerbation , arthritis , granulocyte , extracorporeal , gastroenterology , immunology , surgery , platelet
The G‐1 column is an extracorporeal type granulocytapheresis device packed with 220 g cellulose acetate beads to which granulocytes and monocytes specifically adhere. A total of 59 rheumatoid arthritis patients with elevated granulocyte counts from 4 hospitals in Japan received 2 apheresis sessions of 1 h duration/week for a total of 8 times over a period of 4 weeks. About 55 % of the leukocytes which entered the G‐1 column were adsorbed onto the beads; 95% were granulocytes, 3.5% monocytes, and 0.4% lymphocytes. Clinical and efficacy assessments showed improvements in swollen joints (p < 0.01), tender joints (p < 0.001), the active joint score (p < 0.001), duration of morning stiffness (p < 0.01), and grip strength (p < 0.001). In good responders, the improvements were observed for up to 12 weeks following the last apheresis. Exacerbation was noted in 2 patients. It is suggested that the efficacy of the G‐1 column is attributable to the removal or suppression of hyperactive leukocytes and inflammatory cytokines, inducing a kind of immunomodu‐lation.