The present study describes the use of a new
polyacrolein microsphere (acrobead)
protein A column. This method enables
immunomodulation by the perfusion of whole blood. The efficacy of the column and its adverse effects following perfusion of blood of patients with
immune thrombocytopenic purpura (
ITP) or
malignancies were investigated. Concurrent experiments in which blood was perfused through an acrobead
lactoglobulin column were carried out. Cellular blood components were mildly affected during the procedure. A moderate decrease in platelet number, to a nadir of 90 x 10(3) per microL (90 x 10(9)/L), was documented. During the
hemoperfusion of
ITP patients' blood, plasma
hemoglobin reached levels of 25 to 40 mg per dL, a level similar to that found in banked blood during storage. Plasma
tumor necrosis factor level, which serves as an
indicator of monocytic activation, increased after 90 minutes of
hemoperfusion.
IgG and
immune complexes were removed. The specific activities (removal of mg Ig/mL bead) of acrobead
protein A columns, using blood from patients with
ITP or
malignancies, were 4.9 and 4.5 mg
IgG per mL of bead, respectively. The diminution of platelet-specific
IgG in the plasma of patients with
ITP was documented as well. There was no activation of the fibrinolytic system as examined by D-dimers. The use of this new technique, which incorporates the method of direct
hemoperfusion, is suggested for future clinical studies.