Anti-dsDNA antibody kinetics during in vivo apheresis in systemic lupus erythematosus patients and in an in vitro apheresis model

Abstract

Levels of anti‐dsDNA measured just after an immunoadsorption procedure in systemic lupus erythematosus (SLE) patients are sometimes paradoxically larger than those measured just before the procedure. A 1:100 in vitro single‐compartment immunoadsorption system model was devised to determine which of two models, one‐ or two‐compartment, more closely approximates the kinetics of anti‐dsDNA during apheresis procedures. Ten SLE patients were employed in this study. A total of 4,100 ml of plasma was passed through the dextran sulfate cellulose columns during one clinical apheresis session. In eight of ten patients, the log of RIA‐measured anti‐dsDNA titers decreased linearly as treated plasma volume increased, in both the clinical procedure and the experimental model. The mean adsorption efficacy in the clinical apheresis procedure and in the in vitro model was 0.37 and 0.27, respectively. However, in one patient the RIA‐measured level of anti‐dsDNA increased during the apheresis procedure; this phenomenon was mirrored in the model (definitely a single pool model). In contrast, the level of anti‐dsDNA, as measured by ELISA, decreased in accordance with the increase of treated plasma volume in both the clinical and the in vitro apheresis procedures. Therefore, an increased titer of anti‐dsDNA as measured by RIA immediately following clinical apheresis cannot be accounted for exclusively by an inflow of antibodies from a secondary (extravascular) pool into the circulating plasma. In short, a one‐compartment model is applicable and an explanation must be sought elsewhere. © 1996 Wiley‐Liss, Inc.

The Role of Immunoadsorption Using Dextran‐Sulfate Cellulose Columns in the Treatment of Systemic Lupus Erythematosus

“…However, in one patient, the level of anti‐DNA, as determined by RIA, paradoxically increased during the apheresis procedure (15). Accordingly, the anti‐DNA titer just after the procedure became larger than that before the treatment.…”

“…A 1:100 in vitro scale, single-compartment immunoadsorption system model was devised to analyze the antibody kinetics during treatment (15). In 8 of 10 patients, the log of RIA-measured anti-DNA titers decreased in a linear manner in accordance with the increased treated plasma volume, in both the clinical procedures and the experimental model.…”

Mizoribine as an effective combined maintenance therapy with prednisolone in child‐onset systemic lupus erythematosus

“…Recently, a new device has been developed which can effectively remove effectively autoantibodies and unknown materials from the blood of patients with SLE 41−45 . Although the effectiveness of this treatment itself was limited and did not last long, this therapy is now known to be useful following the combination with immunosuppressive drugs in patients with severe SLE.…”

Dextran Sulfate (Selesorb) Plasma Apheresis Improves Vascular Changes in Systemic Lupus Erythematosus

“…Apheresis with dextran sulfate is widely used for low‐density lipopolysaccharide‐cholesterol removal (3) and was previously used for apheresis in SLE in Japan (1,4–8). Suzuki et al (9) have shown that cationic anti‐ds‐DNA antibodies bind to dextran sulfate in in vivo and in vitro models. No such antibodies could be detected in the presented case at the beginning of apheresis.…”