A New Treatment for Dialysis-Related Amyloidosis with β 2-Microglobulin Adsorbent Column

Abstract

Dialysis-related amyloidosis (DRA) is characterized by the presence of beta 2-microglobulin (beta 2-m) in the plasma. In order to eliminate beta 2-m from the circulating blood, the beta 2-m selective adsorbent for direct hemoperfusion (DHP) was developed. A DHP column (BM-01), containing 350 ml of the adsorbent, was subjected to clinical trials. The column was connected with a PAN (AN69) membrane dialyzer in series and used 3 times a week for 1 week (11 patients), 4 weeks (5 patients), 6 months (1 patient) and 12 months (2 patients). The percent reduction (%) of beta 2-m was for 16 patients (for 1 or 4 weeks), more than 65, and for 3 patients (for more than 6 months), 76.5 +/- 4.9, 73.5 +/- 5.7, 72.2 +/- 6.2. At the end of each session, beta 2-m plasma levels were found to be below 10 mg/L, with 3.4 mg/L being the lowest. The total amounts of beta 2-m removed were 172.5 +/- 22.3, 257.0 +/- 75.6, 157.6 +/- 32.2 and 429.8 mg/session at max. Two out of these three patients had a favorable effect on joint symptoms and ocular fundus. It can be concluded that this selective adsorption therapy may delay the progression of DRA, and is worth considering for wide application.

Effects of Direct Hemoperfusion with a β₂-Microglobulin Adsorption Column on Hypercytokinemia in Rats

“…The BMG adsorption column consists of porous cellulose beads (pores of approximately 460 Ìm in diameter) [6], and has a ligand of the hexadecyl group on the surface and is able to adsorb BMG by hydrophobic interaction [7]. Whereas, the BMG adsorption column appears to adsorb various cytokines since they have hydrophobic amino acids like BMG.…”

“…Recently, a ß 2 -microglobulin (BMG) adsorption column (Lixelle ® ; Kaneka, Osaka, Japan), which is a BMGselective adsorbent, has been clinically applied to treat dialysis-related amyloidosis (DRA) [6]. It is easy to use this column, since it can be connected in series to a dialysis membrane on hemodialysis, and the reduction rate of BMG reaches more than 65-80% [7].…”

Effectiveness of β₂-Microglobulin Adsorption Column in Treating Dialysis-Related Amyloidosis: A Multicenter Study

“…The Lixelle column was placed in line with the HD circuit, upstream of the high-flux dialyzer [8]. The dialyzer membranes were composed of polysulfone, cellulose triacetate, modified regenerated cellulose, and polyarylethersulfone.…”

β₂-Microglobulin Dialysis Amyloid and Its Formation: Role of 3-Deoxyglucosone and Advanced Glycation End Products

“…However, the amount of P2M removed de creases with decreasing plasma P2M levels, and, thus, cur rently available blood purification methods cannot nor malize the plasma levels of P2M [138,[157][158][159], Develop ment of adsorbents for P2M is under investigation by using a grafted affinity adsorbent with collagen or gelatin as a ligand [160] or using an immunoadsorbent with a monoclonal antihuman P2M antibody [161], These ap proaches are only experimental and not available for clin ical use. Recently, an adsorbent column for clinical use has been developed to increase P2M removal by direct hemoperfusion [162][163][164], with a consequent favorable effect on joint symptoms. Dialysis using a high-flux mem brane dialyzer with a combination of direct hemoperfu sion using the adsorption column can remove 200-300 mg of (TM.…”