Adsorptive cytapheresis for ulcerative colitis with focus on removing platelets and platelet‐aggregates

Abstract

Introduction: Platelet abnormalities and secondary thrombocytosis are clinical features of ulcerative colitis (UC) and seem to play a relevant role in pathogenesis. This work analyzed the adsorption characteristics of the adsorber Immunopure. Methods: A prospective study was performed to investigate the module in vitro with blood from healthy donors in a down-scaled recirculation model and in vivo in six patients suffering from UC. Furthermore, adsorber beads were investigated by immunofluorescence analyses. Apheresis was performed over 5 weeks at weekly intervals. Results: In vitro as well as in vivo, the module showed a strong adsorption of platelets, monocytes, CD14 + CD16 + monocytes, neutrophils, and platelet leukocyte aggregates (PLAs). Five of the six patients benefited from the treatment (83%), and four (67%) went into remission. On average, the CAI was reduced by 6.4 points. Conclusion: Immunopure treatments improved the course of the disease and were well tolerated. The module strongly adsorbs platelets and plateletaggregates.

Adsorptive cytapheresis in ulcerative colitis: A non‐pharmacological therapeutic approach revisited

“…The standard LCAP session uses higher blood flow rates (50 mL/min) compared with GMA, thus filtering more blood. It removes 90% granulocytes, 79% monocytes, over 55% platelets as well as an average of 50% lymphocytes 21,22 …”

“…A third, more recent, and less widely used technique, Immunopure utilizes polyarylate resin bead columns and a flow‐rate of 30 mL/min, in 1‐hour sessions. The effect of this AC is intermediate between GMA and LCAP, adsorbing 35% granulocytes, 45% monocytes, 45% platelets, and 3% lymphocytes 22,23 …”