Apheresis:A cell-based therapeutic tool for the inflammatory bowel disease  

作　　者：Farah Yasmin Hala Najeeb Unaiza Naeem Abdul Moeed Thoyaja Koritala Salim Surani 

机构地区：[1]Department of Medicine,DOW University of Health Sciences,Karachi 74200,Pakistan [2]Department of Medicine,Mayo Clinic,Rochester,MN 55902,United States [3]Department of Medicine,Texas A&M University,College Station,Texas 77843,United States [4]Department of Anaesthesiology,Mayo Clinic,Rochester,MN 55902,United States

出　　处：《World Journal of Clinical Cases》2022年第21期7195-7208,共14页世界临床病例杂志

摘　　要：Inflammatory Bowel Disease(IBD)is a hallmark of leukocyte infiltration,followed by the release of cytokines and interleukins.Disease progression to Ulcerative Colitis(UC)or Crohn’s Disease(CD)remained largely incurable.The genetic and environmental factors disrupt enteral bacteria in the gut,which hampers the intestinal repairing capability of damaged mucosa.Commonly practiced pharmacological therapies include 5-aminosalicylic acid with corticosteroids and tumor necrosis factor(TNF)-α.New interventions such as CDP571 and TNF-blocking RDP58 report the loss of patient response.This review discusses the non-pharmacologic selective granulocyte–monocyte-apheresis(GMA)and leukocytapheresis(LCAP)that have been proposed as treatment modalities that reduce mortality.GMA,an extracorporeal vein-to-vein technique,presents a strong safety profile case for its use as a viable therapeutic option compared to GMA's conventional medication safety profile.GMA reported minimal to no side effects in the pediatric population and pregnant women.Numerous studies report the efficacious nature of GMA in UC patients,whereas data on CD patients is insufficient.Its benefits outweigh the risks and are emerging as a favored nonpharmacological treatment option.On the contrary,LCAP uses a general extracorporeal treatment that entraps leukocytes and suppresses cytokine release.It has been deemed more efficacious than conventional drug treatments,the former causing better disease remission,and maintenance.Patients with UC/CD secondary to complications have responded well to the treatment.Side effects of the procedure have remained mild to moderate,and there is little evidence of any severe adverse event occurring in most age groups.LCAP decreases the dependence on steroids and immunosuppressive therapies for IBD.The review will discuss the role of GMA and LCAP.

关 键 词：Inflammatory bowel disease APHERESIS Granulocyte-monocyte-apheresis LEUKOCYTAPHERESIS TNF-α Ulcerative colitis Crohn’s disease 

分 类 号：R574[医药卫生—消化系统]