Artif Organs 2002 Feb;26(2):140-4
Schneidewind-Muller JM, Winkler RE, Tiess M, Muller W, Ramlow W.
Dialysis-Group North and Laboratory-Community North, Rostock, Germany.
The success of apheresis treatment is often measured as a decrease in the detected antibodies and an improvement in different disease-related scores.
Sometimes, however, the seriousness of the disease does not correlate with the antibody level.
During a period of 8 years, 15 patients (3 myasthenia gravis, 1 multiple sclerosis, 2 systemic lupus erythematosus, 3 alloimmunized kidney transplant, 6 rheumatoid arthritis) were treated by protein A immunoadsorption.
Lymphocyte subpopulations (activated T cells, cytolytic T cells, B cells, natural killer cells) and inflammatory proteins (ferritin, C-reactive protein, alpha1-antitrypsin, alpha2-macrogobulin) were analyzed.
After observing clinical outcomes, the patients could be divided into 2 groups, respectively: Group 1, responding patients with remission of disease; and Group 2, delayed-responding patients, who required chronic treatment.
Group 1 patients characteristically showed a greater increase in activated T and cytolytic T cells which correlated with a greater decrease of B cells.
It might be possible that protein A immunoadsorption induced immunomodulation.
Further immunological investigation is required to verify these findings.