%0 Journal Article %A Olga Baranova %A Valerii Voinov %A Olga Baklanova %T 30 years experience of plasmapheresis using in complex treatment of pulmonary sarcoidosis (PS) %D 2014 %J European Respiratory Journal %P P4510 %V 44 %N Suppl 58 %X Aim: To estimate of plasmapheresis (P) efficiency in patients (pts) with PS.Methods. The retrospective analysis of clinical, radiologic, functional, laboratory data was performed after 10 years observation of pts with PS. The 1st group (58 pts) was subjected to P, the 2nd group (54 pts) did not receive P. Glucocorticosteroid (GCS) treatment was administered according to ATS\ERS recommendations. Serum samples were tested for TNF-ag, IL-10,RAIL, and TGF-b1 by ELISA before and after the plasmapheresis. 37 healthy volunteers were examined as a control group. P was used in 6 months. Bone Mineral Density (BMD) was measured by DEXA.Results. After directly P decrease (p<0.05) in proinflammatory cytokines levels: TNF-a, IFN-g and increase (p<0.05) in IL-10,RAIL, and TGF-b1 were revealed, that explains the pathogenetic mechanisms of therapeutic action of P. After 10 years clinical improvement in 40 (68.9%) ptsof 1st group and only 21 pts (38.8%) of 2nd group was observed. We found tendency to improvement of average values PFTs in pts receiving P. In 1st group favorable course was observed in 38 pts (65 %), relapsing – in 11 (19%), stable – in 5 (9 %), progressive – in 4 pts (7%). In 2nd group favorable course was observed in 24 pts (45 %), relapsing – in 18 (33%), stable – 4 (7%), progressive – 8 pts (15%). P has been found to maintain improvement and stable remission with low-dose GCS therapy. BMD decreased significantly more often than subjects in 2nd group (OR=3.87, p<0.01).Conclusion. This investigation showed that plasmapheresis effectiveness in complex treatment of PS pts leads to improvement and stabilization of pathologic process and permits to decrease dose of GCS in some cases. %U