Adsorptive granulocyte and monocyte apheresis for refractory Crohn’s disease: an open multicenter prospective study View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2004-12

AUTHORS

Yoshihiro Fukuda, Toshiyuki Matsui, Yasuo Suzuki, Kazunari Kanke, Takayuki Matsumoto, Masakazu Takazoe, Takayuki Matsumoto, Satoshi Motoya, Terasu Honma, Koji Sawada, Tsuneyoshi Yao, Takashi Shimoyama, Toshifumi Hibi

ABSTRACT

BackgroundActive 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.MethodsTwenty-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 (GCAP) as an adjunct to their ongoing medication. GCAP was performed with an Adacolumn, which adsorbs granulocytes, monocytes, and a small fraction of lymphocytes (FcγR and complement receptor-bearing 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.ResultsDuring 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 (P = 0.0005), 2.54 ± 1.5 (P = 0.0224), and 165 ± 29 (P = 0.0327), respectively.ConclusionsGCAP could be effective for inducing remission and improving quality of life in patients with active CD that is refractory to conventional therapy. More... »

PAGES

1158-1164

References to SciGraph publications

  • 1989-10. Dietary antigens as aggravating factors in Crohn's disease in DIGESTIVE DISEASES AND SCIENCES
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    http://scigraph.springernature.com/pub.10.1007/s00535-004-1465-z

    DOI

    http://dx.doi.org/10.1007/s00535-004-1465-z

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1009327356

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/15622479


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