Suppression of interleukin-1?- and tumor necrosis factor-�-induced inflammatory responses by leukocytapheresis therapy in patients with ulcerative colitis

Abstract

The relationship of parasitic liver disease to cholangiocarcinoma has long been debated, and it has been reported that cholangiocarcinoma is associated with opisthorchiasis viverrini. We report herein a rare case of cholangiocarcinoma associated with schistosomiasis japonica. A 76-year-old Japanese man with jaundice was diagnosed with cholangiocarcinoma. Radical resection was not done because of hepatic arterial and portal vein invasion. Biliary microwave tissue coagulation therapy was performed with placement of a metallic stent endoprosthesis. Twenty-two months after the treatment, however, the patient died from hematemesis. Autopsy findings revealed that there was no distant metastasis, even in the area of regional lymph node metastasis. The primary tumor in the hepatic hilar region had been replaced by necrotic debris resulting from the microwave therapy, and an expandable metallic stent was located in the center of the debris. Histological findings showed schistosome eggs, which were old and microcalcified, in veins in the colonic submucosa. Glisson's fibrosis around the cancer lesion suggested that schistosomiasis japonica and cholangiocarcinoma can occur together with severe chronic inflammation of the portal vein.

Safety and tolerability of a modified filter‐type device for leukocytapheresis using ACD‐A as anticoagulant in patients with mild to moderately active ulcerative colitis. Results of a pilot study

“…The median histologic score decreased from 3.5 (range [3][4][5]) at entry to 2.0 (range [1][2][3][4]) at the end of the study in the four responders.…”

“…Leukocytapheresis (LCAP) techniques for adsorption of activated white blood cells from peripheral blood in patients with flares of UC have been reported to down-regulate the formation of inflammatory cytokines and to tilt cytokine profiles toward a state of immunologic tolerance [1][2][3][4]. Two techniques using cell-adsorbing columns are commercially available and are designated LCAP and Granulocyte and monocyte apheresis (GMA), respectively.…”

Selection of Anticoagulants for Leukocytapheresis Therapy in Cases of Active Ulcerative Colitis

“…LCAP adsorbs and removes chronically activated peripheral blood leukocytes, thereby reducing the number of immunocytes that can infiltrate the intestinal mucosa, increasing the production of anti-inflammatory cytokines and inhibiting the production of active oxygen species by removing activated platelets. In fact, following LCAP and granulocyte and monocyte adsorptive apheresis, we observed downregulation of IL-6, IL-8 and L-selectin and upregulation of anti-inflammatory cytokines such as IL-4, IL-1 receptor antagonist and soluble TNF-␣ receptors [11][12][13] . Several clinical reports have reported on the effectiveness and safety of LCAP and granulocyte and monocyte adsorptive apheresis in the treatment of patients with active-state UC [2,4,[14][15][16] , steroid-dependent UC [17] and active UC in children [18] .…”

Therapeutic Efficacy of Leukocytapheresis in a Pregnant Woman with Refractory Adult-onset Still's Disease

“…However, the mechanisms by which LCAP induces clinical remission remain unknown. The mechanism of LCAP in inflammatory disease is speculated to involve the removal of activated leukocytes and inflammatory cytokines and induction of anti-inflammatory cytokines (15)(16)(17). The WBC count and serum levels of TNF-α, IL-18, MCP-1/CCL2, MIP-1α/CCL3, IL-8/CXCL8 and IP-10/CXCL10 are reduced after LCAP treatment.…”