Decrease of reactive-oxygen-producing granulocytes and release of IL-10 into the peripheral blood following leukocytapheresis in patients with active ulcerative colitis

AIM: To investigate the clinical efficacy of leukocytapheresis (LCAP) in patients with active ulcerative colitis (UC), and to elucidate the mechanisms by determining the changes in the cytokine levels in the peripheral blood and of the functions of the peripheral blood leukocytes in these patients.METHODS: The subjects were 19 patients with active UC, with a mean clinical activity index (CAI) of 9.2. The LCAP was conducted using Cellsorba E. In each session of LCAP, 2-3 L of blood at the flow rate of 30-50 mL/min was processed. The treatment was carried out in approximately 1-h sessions, once a week, for 5-10 wk. Blood samples for determination of the cytokine levels were collected from the inflow side of the column (site of dehematization; at the start of LCAP) and outflow side of the column (at the end of LCAP). Blood samples for the determination of reactive-oxygen-producing cells were collected from the peripheral blood before and after LCAP.RESULTS: LCAP resulted in clinical improvement in all the 19 patients of UC recruited for this study. Remission (CAI: ≤4) was noted in 15 (79%) of the 19 patients. The blood level of the pro-inflammatory cytoline IL-6 was found to be decreased following treatment by LCAP, and the level of the anti-inflammatory cytokine IL-10 at the outflow side of the LCAP column was found to be significantly elevated as compared to that at the inflow side of the column. The reactive-oxygen-producing granulocytes in the peripheral blood of UC patients was increased as compared to that in healthy persons and the increase was found to be decreased following treatment by LCAP.CONCLUSION: LCAP exerted a high therapeutic efficacy in patients with active UC. Our findings suggest that LCAP is associated with enhanced production of the inhibitory cytokine IL-10 to indirectly inhibit the functions of the inflammatory leukocytes, and that inflammation is also considerably attenuated by the direct removal of reactiveoxygen-producing neutrophils from the peripheral blood.

Effects of adacolumn selective leukocytapheresis on plasma cytokines during active disease in patients with active ulcerative colitis

瞄准：调查在临床的活动索引的 ulcerative (UC )( 蔡) 和 IL-1ra， IL-10， IL-6 和 IL-18 的传播层次之间的关系。方法：IL-1ra， IL-10， IL-6 和 IL-18 的血层次与活跃 UC 在 31 个病人被测量，吝啬的蔡是 11.1，从 5-25 ；并且是的 12 个健康个人控制。病人们与 Adacolumn 被给粒细胞和单核白血球 adsorptive 词首字母的脱落(GMA ) 。忍受 FcgammaR 并且补充受体的白细胞被吸附到列 leucocytapheresis 搬运人。每个病人能在 8 wk 上收到多达 11 个 GMA 会议。结果：我们发现了在蔡和 IL-10 之间的强壮的关联(r = 0.827， P 【 0.001 ) ， IL-6 (r = 0.785， P 【 0.001 ) 并且 IL-18 (r = 0.791， P 【 0.001 ) 。IL-1ra 没与蔡一起被相关。后面的 GMA 治疗， 31 个病人中的 24 个完成了宽恕，所有 4 cytokines 的层次掉在健康控制里到层次。进一步， IL-1ra 和 IL-10 的血层次在从遵守了搬运人的白细胞建议版本的 60 min 在列流出和流入增加了。