RT Journal Article
SR Electronic
T1 Efficacy of high-dose leukocytaphereis using extracorporeal circulation through a large leukocyte-removal filter column in patients with refractory asthma
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 3423
VO 38
IS Suppl 55
A1 Tamotsu Ishizuka
A1 Akio Koike
A1 Motoaki Hatori
A1 Shinichi Matsuzaki
A1 Yosuke Kamide
A1 Haruka Aoki
A1 Takeshi Hisada
A1 Hiroaki Tsurumaki
A1 Akihiro Ono
A1 Yasuhiko Koga
A1 Kunio Dobashi
A1 Kazuhiro Suzuki
A1 Masatomo Mori
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/3423.abstract
AB Leukocytapheresis (LCAP) as well as granulocyte and monocyte adsorptive apheresis (GMA) using extracorporeal circulation through the column has been used to treat inflammatory bowel disease and rheumatoid arthritis in Japan. We previously reported that GMA improved the peek expiratory flow rate (PEFR) in patients with severe asthma. To evaluate the efficacy of high-dose leukocytapheresis (pulse LCAP) using a large leukocyte-removal filter column (Cellsorba® CS-180S, Asahikasei Kuraray Medical, Tokyo, Japan) in patients with refractory asthma, we conducted a clinical trial. Pulse LCAP was performed 2 sessions at 1-week interval and 5 L of blood was filtered per session. The average PEFR during the 4 weeks just after the second LCAP in each patient was compared with that during the 4 weeks just before the first LCAP as a primary end point. The sum total of asthma control test (ACT) score at 4 weeks after the second LCAP was compared with that just before the first LCAP as a secondary end point. We evaluated the change of the fraction of exhaled nitric oxide (FENO) in each patient before and after pulse LCAP as a biomarker of eosinophilic airway inflammation. Five patients fulfilled the ATS criteria for refractory asthma participated in this trial up to now. The morning PEFR and the ACT score were increased in all patients. Although FENO was abnormally increased in four patients in spite of the standard therapy, it was decreased after pulse LCAP. Pulse LCAP might serve as a non-pharmacological strategy to induce clinical improvement in patients with refractory asthma through its unique anti-inflammatory effects.