Therapeutic Apheresis and Immunosuppression in Immunologic Diseases: A Review and Own Observations

Autoimmune diseases based on an immune pathogenesis produce autoantibodies and circulating immune complexes, which cause inflammation in the tissues of various organs. In most cases, these diseases have a bad prognosis without treatment, and the treatment is complicated in these diseases. With the introduction of therapeutic apheresis (TA), since more than 45 years, has led in combination with immunosuppressive therapies to a steady increase in survival rates over the last decades. TA is accepted as supportive therapy in all antibodymediated diseases. Further modern therapy are different human monoclonal antibodies (HMA) with or without TA. Besides, the pathological aspects, the first-line and second-line therapies for immunologic diseases, such as renal, neurological, hematological, dermatological, and autoimmune diseases, which are possible, are shown. For immunological diseases that can be treated with TA, the guidelines of the Apheresis Applications Committee of the American Society for Apheresis are cited. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid improvement.