[The use of therapeutic apheresis in neurological diseases and comparison between plasma exchange and immunoadsorption].

Abstract

The use of plasmapheresis in neurological diseases with immune-mediated pathogenesis is widely certified. In recent years, the technological evolution of the dialysis membranes allowed to accompany the classical plasma exchange (PEX) treatment of apheresis by means of selective adsorption (IA). It has proved to be of equal therapeutic efficacy and, at the same time, devoid of most of the PEX side effects. The recent guidelines of the American Society for Apheresis (ASFA) and, later, the American Academy of Neurology, outlined directions and diagrams for the application of the method that has found wide use in many neurological diseases on the basis of auto-antibodies; in particular in Myasthenia Gravis, Guillain-Barre Syndrome, Multiple Sclerosis and Chronic Demyelinating Polyradiculoneuropathy. We add our experience in the treatment of 13 patients suffering from Myasthenia Gravis, treated over a four years period with filters containing tryptophan immunoadsorption in polyvinyl alcohol gel. The results confirm the achievement of a rapid regression of clinical symptoms, together with the rapid fall in the levels of antibody against acetylcholine-receptor. Therefore, the method of AI is to be considered of equal therapeutic efficacy of PEX, providing greater security in its use.

• Authors: C Loschiavo, M Grecò, A Polo, R Del Colle
• Journal: Giornale italiano di nefrologia : organo ufficiale della Societa italiana di nefrologia (G Ital Nefrol) 2015 Jan-Feb Vol. 32 Issue 1 ISSN: 1724-5990 [Electronic] Italy
• Vernacular Title: Utilizzo dell'aferesi terapeutica in corso di patologie neurologiche comparazione tra plasmaexchange ed immunoadsorbimento.
• PMID: 25774587 (Publication Type: Comparative Study, Journal Article, Review)

Chemical References

• Receptors, Cholinergic

Topics

• Blood Component Removal (methods)
• Guillain-Barre Syndrome (immunology, therapy)
• Humans
• Immunosorbent Techniques
• Multiple Sclerosis (immunology, therapy)
• Myasthenia Gravis (immunology, therapy)
• Plasma Exchange
• Polyradiculoneuropathy, Chronic Inflammatory Demyelinating (immunology, therapy)
• Receptors, Cholinergic (immunology)