Leukocytapheresis Using a Leukocyte Removal Filter

Abstract

Leukocytapheresis (LCAP) long has been investigated with a leukocyte removal filter for the treatment of various kinds of autoimmune related and inflammatory diseases such as rheumatoid arthritis, inflammatory bowel disease, multiple sclerosis, and so on. A lot of patients with such diseases have been reported to respond to LCAP. Asahi Medical Co. has developed the leukocyte removal filter Cellsorba and an extracorporeal treatment unit Plasauto LC so that the LCAP technique can be performed easily with a high performance filter, easy attachment of the blood circuit tubing set, and automatic operation. Cellsorba E has been listed as a medical device reimbursed by Japanese national health insurance to be used in LCAP for active ulcerative colitis since October 2001. Although the effective mechanism of LCAP is still controversial, the removal of activated leukocyte from the peripheral blood and the reaction by blood contacting materials in Cellsorba can be triggers of the immunomodulation for the treatment of immune disorder. This review introduces the development of LCAP technologies and several reports on therapeutic results.

Leukocytapheresis for the treatment of acute exacerbation of idiopathic interstitial pneumonias: a pilot study

“…This is similar to the previous studies in patients with rheumatoid arthritis and ulcerative colitis and healthy volunteers (23)(24)(25). It has been reported that the peripheral blood platelets were removed while passing through the column (26).…”

Endoscopic findings can predict the efficacy of leukocytapheresis for steroid-naive patients with moderately active ulcerative colitis

“…These leukocytes include granulocytes, lymphocytes and monocytes. Almost 100% of granulocytes and monocytes and 60% of lymphocytes are removed by removal filter [24,25] . It has been reported that 73.3% of steroid-refractory patients with UC enter remission after LCAP [26] .…”

Systemically Circulating Colitogenic Memory CD4+T Cells May Be an Ideal Target for the Treatment of Inflammatory Bowel Diseases

“…4 3 How does leukocytapheresis contribute to suppressing the pathology in the hemodynamics of colitogenic memory CD4 + T cells described in the previous section? The principal methods of leukapheresis used clinically are granulocyte and monocyte adsorption apheresis (GCAP; Adacolumn), 44 which chiefly removes granulocytes and monocytes, and leukocytapheresis (LCAP; Cellsorba), 45 which removes lymphocytes, monocytes and granulocytes as a whole. We recently reported that LCAP therapy selectively removed CD4 + CD45RO + CD62L -T EM cells, which have a similar phenotype of murine colitogenic memory CD4 + T EM cells without affecting CD4 + CD25 + Foxp3 + T R cells, which suppress immunity.…”