Treatment of Systemic Lupus Erythematosus by Extracorporeal Immunoadsorption

Palmer, Arthur; Gjörstrup, P.; Severn, Andrew; Welsh, Ken I.; Taube, David

doi:10.1016/s0140-6736(88)92553-6

Cited by 42 publications

(9 citation statements)

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“…1,77 The rationale for the application of immunoadsorption stems from its use in other autoimmune, antibody-mediated disorders. 78,79 In small studies, immunoadsorption in patients with dilated cardio myopathy has been shown to improve LV systolic function and levels of heart failure biomarkers, reduce myocardial inflammation, and ameliorate important haemodynamic parameters, including systemic vascular resistance and cardiac output indices. 77,[80][81][82][83] Although promising, current guidelines do not give recommendations for the use of immunoadsorption in patients with myocarditis, owing to the lack of large-scale, randomized, controlled trials to evaluate this treatment strategy.…”

Section: Immunomodulatory Therapymentioning

confidence: 99%

Viral myocarditis—diagnosis, treatment options, and current controversies

et al. 2015

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Myocarditis--a frequent cause of dilated cardiomyopathy and sudden cardiac death--typically results from cardiotropic viral infection followed by active inflammatory destruction of the myocardium. Characterization of this disease has been hampered by its heterogeneous clinical presentations and diverse aetiologies. Advances in cardiac MRI and molecular detection of viruses by endomyocardial biopsy have improved our ability to diagnose and understand the pathophysiological mechanisms of this elusive disease. However, therapeutic options are currently limited for both the acute and chronic phases of myocarditis. Several randomized, controlled trials have demonstrated potential benefit with immunosuppressive and immunomodulatory therapies, but further investigations are warranted. In this Review, we explore the pathophysiology, natural history, and modes of diagnosis of myocarditis, as well as evidence-based treatment strategies. As novel imaging techniques and human in vitro models of the disease emerge, the landscape of therapies for myocarditis is poised to improve.

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Section: Immunomodulatory Therapymentioning

confidence: 99%

Viral myocarditis—diagnosis, treatment options, and current controversies

et al. 2015

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“…Circulating antibodies are extractable by IA. Removal of circulating antibodies by IA has been successfully used for treatment of a number of autoimmune diseases such as Goodpasture syndrome or lupus erythematodes [23,24]. An initial uncontrolled study was conducted with the purpose of ascertaining the acute haemodynamic effects of IA in patients with severe heart failure due to DCM [25].…”

Section: Non-specific Immunadsorption As a New Therapeutic Principle mentioning

confidence: 99%

Non-specific immunoadsorption in patients with dilated cardiomyopathy: Mechanisms and clinical effects

Felix¹,

Staudt²

2006

International Journal of Cardiology

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“…The knowledge about the crucial role of cardiac autoantibodies in the development and progression of DCM resulted in a novel treatment approach, namely application of immunoadsorption (IA) therapy by which circulating antibodies can be extracted from the blood. Removal of circulating antibodies by IA has been successfully employed for a number of autoimmune diseases such as Goodpasture's syndrome and lupus erythematodes (Bygren et al 1985;Palmer et al 1988). IA is a type of plasmapheresis and can be described as an extracorporal blood purification procedure which uses filter columns to remove circulating autoantibodies (Dörr 2002).…”

Section: Immunoadsorption As a Therapeutic Option In Dcmmentioning

confidence: 99%

Use of Biomarkers for the Prediction of Treatment Response: Immunoadsorption in Dilated Cardiomyopathy as a Clinical Example

Dörr

Völker

Felix

2015

Individualized Medicine

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In this article, we outline a clinical example illustrating how integrated analyses of biomarkers might be used for the prediction of treatment response. We report findings from a pilot study that investigated the hemodynamic effects of a novel treatment option, immunoadsorption with subsequent IgG substitution (IA/IgG), in patients with dilated cardiomyopathy. Several previous studies have shown that this treatment leads to a significant improvement of cardiac function and relief of symptoms. Response to this therapy is, however, characterized by a wide inter-individual variability. In a pilot study, we tested the value of clinical, biochemical and molecular parameters for prediction of the response to IA/IgG. This study demonstrated that combined assessment of two markers (negative inotropic activity of antibodies in the blood and gene expression patterns derived from myocardial biopsies) predicts response to this therapy with an extremely high sensitivity and specificity, thereby enabling appropriate selection of patients who most likely benefit from this therapeutic intervention. Further studies will screen for biomarker signatures in blood, which do not depend on endomyocardial biopsies, and will compare responders and non-responders with respect to other molecular markers (e.g. plasma proteome, metabolome and microRNA profiles as well as whole blood transcriptome signatures). In the future, such strategies might facilitate selection of patients with dilated cardiomyopathy who are responders not only to immunoadsorption therapy but also to other heart failure treatments for which a heterogeneous response is observed and thus will help to offer more effective treatments to affected patients.

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Treatment of Systemic Lupus Erythematosus by Extracorporeal Immunoadsorption

Cited by 42 publications

References 1 publication

Viral myocarditis—diagnosis, treatment options, and current controversies

Viral myocarditis—diagnosis, treatment options, and current controversies

Non-specific immunoadsorption in patients with dilated cardiomyopathy: Mechanisms and clinical effects

Use of Biomarkers for the Prediction of Treatment Response: Immunoadsorption in Dilated Cardiomyopathy as a Clinical Example

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