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- Title
Adsorptive granulocyte and monocyte apheresis for refractory Crohn’s disease: an open multicenter prospective study.
- Authors
Fukuda, Yoshihiro; Matsui, Toshiyuki; Suzuki, Yasuo; Kanke, Kazunari; Matsumoto, Takayuki; Takazoe, Masakazu; Motoya, Satoshi; Honma, Terasu; Sawada, Koji; Yao, Tsuneyoshi; Shimoyama, Takashi; Hibi, Toshifumi
- Abstract
<em>Background</em>. Active Crohn's disease (CD) is often associated with elevated levels of platelets, granulocytes, and monocytes that are activated and resistant to apoptosis. The level of neutrophils in the intestinal mucosa has been quantitatively related to the severity of intestinal inflammation in CD. We postulated that patients with CD that is refractory to conventional medications might respond to a reduction of granulocytes and monocytes by adsorptive apheresis. <em>Methods</em>. Twenty-one patients with a CD activity index (CDAI) of 200-399 and unresponsive to standard medication, which included nutritional intervention, received granulocyte and monocyte adsorptive apheresis (UCAP) as an adjunct to their ongoing medication. (CAP was performed with an Adacolumn, which adsorbs granulocytes, monocytes, and a small fraction of lymphocytes (FcγR and complement receptor-hearing leucocytes). Patients received one GCAP session/week for 5 consecutive weeks. CDAI, International Organization for the Study of Inflammatory Bowel Disease (IOIBD), and IBD questionnaire (IBDQ) scores were evaluated. <em>Results</em>. During the initial conventional/nutritional therapy, no significant improvement was seen in any patient. However, at week 7 of GCAP therapy, significant improvements in CDAI, IOIBD, and IBDQ scores were observed. The CDAI, IOIBD and IBDQ scores before GCAP were 275.6 ± 54.2, 3.4 ± 1.4, and 152 ± 22, respectively. The corresponding values after GCAP were 214.8 ± 89.2 (<em>P</em> = 0.0005), 2.54 ± 1.5 (<em>P</em> = 0.0224), and 165 ± 29 (<em>P</em> = 0.0327), respectively. <em>Conclusions</em>. GCAP could he effective for inducing remission and improving quality of life in patients with active CD that is refractory to conventional therapy.
- Subjects
INFLAMMATORY bowel diseases; LYMPHOCYTES; MONOCYTES; INFLAMMATION; GRANULOCYTES; NEUTROPHILS
- Publication
Journal of Gastroenterology, 2004, Vol 39, Issue 12, p1158
- ISSN
0944-1174
- Publication type
Article
- DOI
10.1007/s00535-004-1465-z