Comparison of Lymphocyte Depletion and Clinical Effectiveness on Filtration Leukocytapheresis in Patients with Rheumatoid Arthritis

Abstract

We evaluated the relationship between the clinical benefit of filtration leukocytapheresis (LCP) and the number of removed leukocytes in patients with rheumatoid arthritis (RA). LCP was performed in 31 drugresistant RA patients. LCP was carried out 3 times with 1 week separating each session. Assessment of RA before and after LCP showed a substantial and rapid improvement in tender joint counts, swollen joint counts, and patients' and physicians' assessments. Careful analysis indicated that 19 of 31 patients with RA showed Ն20% improvement following LCP therapy. The number of leukocytes in the peripheral blood significantly decreased during each session of LCP. However, there was no significant decrease in the number of circulating blood cells during the study period. No adverse reactions or complications were noted. There was no significant difference in any indices of clinical activity and the removal rates of leukocytes between responders and nonresponders. The total numbers of removed lymphocytes in responders were significantly higher than those in nonresponders (responders 64.1 × 10 8 versus nonresponders 50.7 ×10 8 , p < 0.05). The relationship between clinical effectiveness and the number of removed granulocytes and monocytes was not statistically significant. Our results suggest that filtration LCP to remove leukocytes from the peripheral blood, especially lymphocytes, exerts an immunomodulatory effect in patients with RA.

Efficacy of High‐Throughput Leukocytapheresis for Rheumatoid Arthritis With a Reduced Response to Infliximab

“…Ueki et al. reported that the lymphocyte elimination rate was higher in responders (18). Recently, Eguchi et al.…”

Rosmarinic Acid Induces Apoptosis of Activated T Cells from Rheumatoid Arthritis Patients via Mitochondrial Pathway

“…Numerous therapeutic strategies to treat RA have been designed, based on pathogenesis associated with T cells. Thoracic duct drainage, total lymphoid irradiation (34), lymphocytapheresis (35,36), and anti-T cell Abs (37,38) are examples of therapeutic manipulations for blocking or depleting T cells. Although T-celltargeted therapies alleviate RA initiation and pathogenesis in animal models (8,18), clinical trials to date suggest no remarkable benefits (21,39).…”

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

“…LCAP has been reported as an effective treatment in RA and ulcerative colitis [10][11][12][13]. The mechanism of LCAP in inflammatory diseases is speculated to be through removal of activated WBCs and platelets [13][14][15][16]. Decrease of inflammatory cytokines and increase of anti-inflammatory cytokines after LCAP was reported [17][18][19].…”