Activated platelets as a possible early marker to predict clinical efficacy of leukocytapheresis in severe ulcerative colitis patients

Fukunaga, Ken; Fukuda, Yoshihiro; Yokoyama, Yoko; Ohnishi, Kunio; Kusaka, Takeshi; Kosaka, Toshio; Hida, Nobuyuki; Ohda, Yoshio; Miwa, Hiroto; Matsumoto, Takayuki

doi:10.1007/s00535-006-1789-y

Cited by 24 publications

(18 citation statements)

References 25 publications

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“…Recent studies have reported that activated platelets were removed by LCAP [12,13]. The removal of activated platelets was due to their adherence to the filter used in LCAP [27]. Yagi et al [28] reported that removal of activated platelets by LCAP resulted in decrease of platelet-derived MPs, which remained at a low level for 1 month in the case of ulcerative colitis.…”

Section: Discussionmentioning

confidence: 97%

Leukocytapheresis (LCAP) decreases the level of platelet-derived microparticles (MPs) and increases the level of granulocytes-derived MPs: a possible connection with the effect of LCAP on rheumatoid arthritis

Umekita

Hidaka²,

Ueno

et al. 2009

Mod Rheumatol

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Microparticles (MPs) are believed to play an important role in inflammatory diseases such as rheumatoid arthritis (RA). Leukocytapheresis (LCAP) is one of the options available for the treatment of RA. We analyzed the levels of MPs in RA, by flow cytometry, especially in relation to the effect of LCAP. Twenty female patients with RA were recruited into this study. Six of the 20 patients with RA further received LCAP. Plasma levels of platelet-derived MPs were high in patients with RA and are correlated with disease activity. LCAP significantly improved RA in all six patients. The numbers of platelet-derived MPs significantly decreased after the first session of LCAP, which was probably due to direct removal by LCAP. Mean numbers of platelet-derived MPs after four sessions of LCAP markedly decreased. The numbers of granulocyte-derived MPs, which are suggested to have an anti-inflammatory effect, were markedly increased after the first session of LCAP. These data suggest that removal of platelet-derived MPs and increase of granulocyte-derived MPs are novel mechanisms of LCAP as effective treatment in RA.

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Section: Discussionmentioning

confidence: 97%

Leukocytapheresis (LCAP) decreases the level of platelet-derived microparticles (MPs) and increases the level of granulocytes-derived MPs: a possible connection with the effect of LCAP on rheumatoid arthritis

Umekita

Hidaka²,

Ueno

et al. 2009

Mod Rheumatol

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“…24 Interestingly, these activated platelets have also increased in patients with active ulcerative colitis and that these cells were reduced after LCAP treatment. 25,26 Therefore, improvement of ESR in the present study might be partially mediated by reduction of increased platelet aggregation activities.…”

Section: Discussionmentioning

confidence: 85%

Enhanced effect of high-dose leukocytapheresis using a large filter in rheumatoid arthritis

Eguchi

Saito

Kondo³

et al. 2007

Mod Rheumatol

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To evaluate the efficacy of high-dose leukocytapheresis (LCAP) using a large filter in patients with refractory rheumatoid arthritis (RA), we conducted a multicenter, nonrandomized, open-label clinical study. Thirty patients with highly active RA were treated with high-dose LCAP performed 3-5 sessions at 1-week intervals using a CS-180S filter (CS-180S group); the treatment involves the removal of leukocytes from a higher blood volume per body weight (100;Sml/kg). The clinical response was evaluated at 4 and 8 weeks after a series of LCAP using the 28-joint disease activity score (DAS28). Similar data of 53 patients treated with conventional LCAP (60;Sml/kg) using a standard filter, CS-100, were compared as a control (CS-100 group). The CS-180S filter demonstrated a higher adsorption capacity for leukocytes, particularly lymphocytes. The CS-180S group exhibited significant improvements in each item of DAS28 after treatment although the CS-100 group did not demonstrate such improvements in the CRP level and the ESR. Compared to the CS-100 group, the patients of the CS-180S group exhibited a tendency toward improvement with respect to the CRP level and ESR (P = 0.057 and 0.041, respectively). According to the EULAR improvement criteria based on DAS28, 60% and 45% of the patients from CS-180S and CS-100 groups achieved moderate or more responses, respectively, at 4 weeks after treatment. These results suggest that compared to conventional LCAP, high-dose LCAP may enhance the suppression of RA disease activity.

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“…According to this evidence, we have hypothesized that this significant platelet removal achieved during LCAP might have an active role in downregulating severe immunological reactions in patients with UC with an acute flare. We have also proved that activated platelets may have potential to predict clinical efficacy of LCAP in severe UC patients 27 …”

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confidence: 76%

Current status and future perspectives of leukocytapheresis for inflammatory bowel disease

Fukunaga

Matsumoto

2012

J of Gastro and Hepatol

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Ulcerative colitis (UC) and Crohn's disease (CD) comprise the idiopathic inflammatory bowel diseases (IBD) of the gut. The etiology of IBD is poorly understood, but an autoimmune disturbance has been suggested to play an important role in this incurable disease. Extracorporeal leukocytapheresis (CAP) is an additional adjunct for IBD patients refractory to other conventional therapies, including steroids. The primary aim of CAP should be to suppress such unwanted immunological response by removing circulating inflammatory cells from the blood stream. The first decade has been passed since CAP was approved by Japanese social health insurance policy. It is therefore now an appropriate opportunity to upgrade and summarize our current understandings and/or future perspectives of this unique non-pharmacological and non-surgical strategy for IBD patients. According to several clinical and basic research reports, an early introduction of CAP should produce higher efficacy as compared with CAP applied sometime after a clinical relapse. Likewise, CAP therapy adjusted to patients' body-weight as well as two treatment sessions per week (intensive regimen) should benefit the efficacy rate. The etiology of IBD is not fully elucidated yet. As a result, the major therapeutic strategies in the Western world have been immunosuppressive therapy, including biologics. CAP is an unusual treatment modality for IBD because it seems to have both effectiveness and safety, which should generally be balanced in this type of illness. We now have to develop future strategies with and without combining biologics to improve the quality of life of IBD patients.

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Activated platelets as a possible early marker to predict clinical efficacy of leukocytapheresis in severe ulcerative colitis patients

Cited by 24 publications

References 25 publications

Leukocytapheresis (LCAP) decreases the level of platelet-derived microparticles (MPs) and increases the level of granulocytes-derived MPs: a possible connection with the effect of LCAP on rheumatoid arthritis

Leukocytapheresis (LCAP) decreases the level of platelet-derived microparticles (MPs) and increases the level of granulocytes-derived MPs: a possible connection with the effect of LCAP on rheumatoid arthritis

Enhanced effect of high-dose leukocytapheresis using a large filter in rheumatoid arthritis

Current status and future perspectives of leukocytapheresis for inflammatory bowel disease

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