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Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis
BACKGROUND: In multiple sclerosis relapses refractory to intravenous corticosteroid therapy, plasma exchange is recommended. Immunoadsorption (IA) is regarded as an alternative therapy, but its efficacy and putative mechanism of action still needs to be established. METHODS: We prospectively treated...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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BioMed Central
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418188/ https://www.ncbi.nlm.nih.gov/pubmed/22537481 http://dx.doi.org/10.1186/1742-2094-9-80 |
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author | Koziolek, Michael J Tampe, Desiree Bähr, Matthias Dihazi, Hassan Jung, Klaus Fitzner, Dirk Klingel, Reinhard Müller, Gerhard A Kitze, Bernd |
author_facet | Koziolek, Michael J Tampe, Desiree Bähr, Matthias Dihazi, Hassan Jung, Klaus Fitzner, Dirk Klingel, Reinhard Müller, Gerhard A Kitze, Bernd |
author_sort | Koziolek, Michael J |
collection | PubMed |
description | BACKGROUND: In multiple sclerosis relapses refractory to intravenous corticosteroid therapy, plasma exchange is recommended. Immunoadsorption (IA) is regarded as an alternative therapy, but its efficacy and putative mechanism of action still needs to be established. METHODS: We prospectively treated 11 patients with multiple sclerosis who had optical neuritis and fulfilled the indications for apheresis therapy (Trial registration DE/CA25/00007080-00). In total, five IA treatments were performed using tryptophan-IA. Clinical activity (visual acuity, Expanded Disability Status Scale, Incapacity Status Scale), laboratory values and visual evoked potentials were measured before, during and after IA, with a follow-up of six months. Moreover, proteomic analyses were performed to analyze column-bound proteins as well as corresponding changes in patients’ sera. RESULTS: After the third IA, we detected an improvement of vision in eight of eleven patients, whom we termed responders. Amongst these, the mean visual acuity improved from 0.15 ± 0.12 at baseline to 0.47 ± 0.32 after the third IA (P = 0.0252) up to 0.89 ± 0.15 (P < 0.0001) at day 180 ± 10 after IA. Soluble interleukin-2 receptor decreased in responders (P = 0.03), whereas in non-responders it did not. Proteomic analyses of proteins adsorbed to IA columns revealed that several significant immunological proteins as well as central nervous system protein fragments, including myelin basic protein, had been removed by IA. CONCLUSIONS: IA was effective in the treatment of corticosteroid-refractory optic neuritis. IA influenced the humoral immune response. Strikingly, however, we found strong evidence that demyelination products and immunological mediators were also cleared from plasma by IA. |
format | Online Article Text |
id | pubmed-3418188 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-34181882012-08-14 Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis Koziolek, Michael J Tampe, Desiree Bähr, Matthias Dihazi, Hassan Jung, Klaus Fitzner, Dirk Klingel, Reinhard Müller, Gerhard A Kitze, Bernd J Neuroinflammation Research BACKGROUND: In multiple sclerosis relapses refractory to intravenous corticosteroid therapy, plasma exchange is recommended. Immunoadsorption (IA) is regarded as an alternative therapy, but its efficacy and putative mechanism of action still needs to be established. METHODS: We prospectively treated 11 patients with multiple sclerosis who had optical neuritis and fulfilled the indications for apheresis therapy (Trial registration DE/CA25/00007080-00). In total, five IA treatments were performed using tryptophan-IA. Clinical activity (visual acuity, Expanded Disability Status Scale, Incapacity Status Scale), laboratory values and visual evoked potentials were measured before, during and after IA, with a follow-up of six months. Moreover, proteomic analyses were performed to analyze column-bound proteins as well as corresponding changes in patients’ sera. RESULTS: After the third IA, we detected an improvement of vision in eight of eleven patients, whom we termed responders. Amongst these, the mean visual acuity improved from 0.15 ± 0.12 at baseline to 0.47 ± 0.32 after the third IA (P = 0.0252) up to 0.89 ± 0.15 (P < 0.0001) at day 180 ± 10 after IA. Soluble interleukin-2 receptor decreased in responders (P = 0.03), whereas in non-responders it did not. Proteomic analyses of proteins adsorbed to IA columns revealed that several significant immunological proteins as well as central nervous system protein fragments, including myelin basic protein, had been removed by IA. CONCLUSIONS: IA was effective in the treatment of corticosteroid-refractory optic neuritis. IA influenced the humoral immune response. Strikingly, however, we found strong evidence that demyelination products and immunological mediators were also cleared from plasma by IA. BioMed Central 2012-04-26 /pmc/articles/PMC3418188/ /pubmed/22537481 http://dx.doi.org/10.1186/1742-2094-9-80 Text en Copyright ©2012 Koziolek et al.; licensee BioMed Central Ltd. http:// http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http:// http://creativecommons.org/licenses/by/2.0 (http://http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Koziolek, Michael J Tampe, Desiree Bähr, Matthias Dihazi, Hassan Jung, Klaus Fitzner, Dirk Klingel, Reinhard Müller, Gerhard A Kitze, Bernd Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title | Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title_full | Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title_fullStr | Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title_full_unstemmed | Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title_short | Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
title_sort | immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3418188/ https://www.ncbi.nlm.nih.gov/pubmed/22537481 http://dx.doi.org/10.1186/1742-2094-9-80 |
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