Mechanism of leukocytapheresis effect in the treatment of ulcerative colitis.

Sawada, Koji; Ohnishi, Kunio; Fukunaga, Ken; Chikano, Shinji; Egashira, Akimitsu; Satomi, Masamichi; Shimoyama, Takashi

doi:10.2177/jsci.22.469

Cited by 4 publications

(3 citation statements)

References 2 publications

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“…[12][13][14] Such LECAM-1 Hi /Mac-1 Low granulocytes have been recognized to have poor adhesiveness to human endothelial cells. 15 Moreover, M-GCAP has been proven to suppress markedly the production of proinflammatory cytokines, such as tumor necrosis factor-α (TNFα) and interleukins 6 and 8 (IL-6, IL-8).…”

Section: Discussionmentioning

confidence: 99%

Poorly controlled ulcerative colitis treated by colectomy during remission induced by extracorporeal leukocyte removal therapy

Fukunaga

Fukuda

Sawada

et al. 2003

Journal of Gastroenterology

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Both monocyte-granulocytapheresis (M-GCAP) and leukocytapheresis (LCAP) are categorized as extracorporeal leukocyte removal therapies (ECCTs). These therapies have been recognized as efficient adjuncts for patients of steroid-resistant ulcerative colitis (UC). This study aimed to consider the adaptation and the limitation of these new therapies from the clinical standpoint based on a case of UC showing strong resistance to high-dose continuous steroid injection therapy. The patient successfully underwent a scheduled colectomy while maintaining remission after applying M-GCAP and LCAP independently. Surgical therapy was chosen because of a deep ulcer in the patient's sigmoid colon, which was assumed to constitute a future risk for perforation. This case suggests that combining ECCT with steroid therapy can maintain such poorly controlled and high-risk UC patients safely for the scheduled colectomy while improving the prognosis by reducing the dosage of steroid efficiently prior to operation.

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Section: Discussionmentioning

confidence: 99%

Poorly controlled ulcerative colitis treated by colectomy during remission induced by extracorporeal leukocyte removal therapy

Fukunaga

Fukuda

Sawada

et al. 2003

Journal of Gastroenterology

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“…However, it is unclear whether the clay‐like adsorption layer was formed entirely by granulocytes, and a more detailed investigation will be needed to determine the mechanism and the elements involved in adsorption. In addition, the kind of relationship between decreased granulocyte adsorption capacity and what appeared to be granulocyte‐granulocyte adhesion is unclear. we believe that continuing this research on topics such as pre‐ and post‐column differences in leukocytes and the clay‐like adsorption layer, and an analysis of the clay‐like adsorption layer that is attached to the beads will lead to a reconsideration of the most suitable amount of treatment and treatment plan to suit the pathological condition.…”

Section: Discussionmentioning

confidence: 99%

Observation of Granulocyte Adsorption in Adacolumn Cellulose Acetate Beads after Granulocytapheresis

et al. 2019

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Adacolumn is a therapeutic mode for ulcerative colitis that achieves therapeutic efficacy through the adhesion of leukocytes to cellulose acetate beads. We used scanning electron microscopy and observed leukocyte adsorption on Adacolumn beads after granulocytapheresis/granulocyte and monocyte adsorption apheresis. We then compared results between two patients with a low and high C‐reactive protein (CRP) levels to determine whether adhesion is affected by a difference in leukocyte activity depending on the level of inflammation. We found that the surface layers of the beads from both patients were covered by a clay‐like layer, and spherical granulocytes were adsorbed here and there on top of it. In cross‐section the adsorbed granulocytes were visible in the clay‐like layer and the surface layer alike. The clay‐like layer had a maximum thickness of approximately 12 μm in the low CRP patient and approximately 50 μm in the high CRP patient, so in the high CRP patient the clay‐like adsorption layer was thicker. Taken together, adsorption onto beads is considered to involve an immunological mechanism. Our findings suggest that granulocytes contact and adhere to each other at the surface layer after adsorption, and that granulocyte‐granulocyte adhesion is enhanced by a higher inflammatory response.

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“…Activated leukocytes induce secretion of cytokines, chemokines and/or complements; then, these mediators could accelerate the activation of leukocytes again. LCAP, using a leukocyte removal filter, has been thought to affect chronic inflammatory diseases such as IBD (2,3,(15)(16)(17)(18)(19)(20)(21) and other collagen disease such as rheumatoid arthritis (22-24) by suppressing and/or shutting Normal, 3.0-5.5 mV/V; NS, not significant; statistical analysis was performed with a paired t-test, and p < 0.05 was considered to be statistically significant. down this cycle of immune response by removing the activated leukocytes with filters.…”

Section: Discussionmentioning

confidence: 99%

A Case Report: First Case of Filtration Leukocytapheresis for a Patient of Aortitis Syndrome Associated with Ulcerative Colitis

Fukunaga

Sawada

Fukuda

et al. 2002

Therapeutic Apheresis

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An 18‐year‐old woman was treated with leukocytapheresis (LCAP) for her combined ulcerative colitis (UC) and aortitis syndrome (AS). Because a close relationship between these two diseases has been suspected based on their etiological and/or pathological findings, we had hypothesized that LCAP, which has satisfactory effects on inflammatory bowel disease such as UC and Crohn's disease might be effective for both her UC and her AS. After informed consent, LCAP therapy was performed once a week for a total of 7 times. Endoscopic remission of the UC was observed. Even though there were no significant improvements in her subjective symptoms of AS such as side‐neck pain and dizziness, objective evidence of improvement was obtained when the patient's condition was compared before and after LCAP by angiography, angio‐magnetic resonance imaging, and the plethysmogram of her fingertips. These results suggest that LCAP may be valuable as a new adjunct therapy for AS.

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Mechanism of leukocytapheresis effect in the treatment of ulcerative colitis.

Cited by 4 publications

References 2 publications

Poorly controlled ulcerative colitis treated by colectomy during remission induced by extracorporeal leukocyte removal therapy

Poorly controlled ulcerative colitis treated by colectomy during remission induced by extracorporeal leukocyte removal therapy

Observation of Granulocyte Adsorption in Adacolumn Cellulose Acetate Beads after Granulocytapheresis

A Case Report: First Case of Filtration Leukocytapheresis for a Patient of Aortitis Syndrome Associated with Ulcerative Colitis

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