| Clinical and endoscopic features of responders and non-responders to adsorptive leucocytapheresis: A report based on 120 patients with active ulcerative colitis. | |
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MedLine Citation:
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PMID: 20934287 Owner: NLM Status: In-Data-Review |
Abstract/OtherAbstract:
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BACKGROUND AND OBJECTIVE: Elevated/activated myeloid leucocytes, like the CD14(+)CD16(+) monocytes are sources of TNF-α, and therefore, selective depletion of these cells by granulocyte/monocyte (GM) adsorption (GMA) should promote remission or enhance drug efficacy. However, studies in ulcerative colitis (UC) reported contrasting efficacy, from an 85% to statistically insignificant level. We investigated patients' demography in responders and non-responders. METHODS: In 120 UC patients, 61 steroid naive and 59 steroid dependent, we looked for entry clinical or endoscopic features to identify responders (or non-responders) to GMA. Patients received up to an 11 Adacolumn GMA sessions over 12 weeks. Patients were clinically and endoscopically evaluated, allowing each patient to serve as her/his own control. Immunohistochemistry on colonic biopsies was to reveal the impact of GMA on leucocyte infiltration of the mucosa. RESULTS: Entry average clinical activity index (CAI) was 12.6, 10-16. An 80 of 120 patients responded (CAI≤4); 45 steroid naïve (73.8%) and 35 steroid dependent (59.3%). Over 900 biopsies were processed. Infiltrating leucocytes were overwhelmingly polymorphonuclear and macrophages around and within crypt abscesses. There was a marked reduction of infiltrating leucocytes in responders. Most non-responders had extensive colonic lesions with virtually no mucosal tissue left at the lesions. CONCLUSIONS: Steroid naïve patients with short duration of UC were the best responders, while patients with deep colonic lesions and extensive loss of the mucosal tissue were non-responders. |
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Authors:
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Tomotaka Tanaka; Hideharu Okanobu; Yoshio Kuga; Yoshikazu Yoshifuku; Hatsue Fujino; Tomohiro Miwata; Takashi Moriya; Toshihiro Nishida; Toshihide Oya |
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Publication Detail:
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Type: Journal Article Date: 2010-10-08 |
Journal Detail:
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Title: Gastroentérologie clinique et biologique Volume: 34 ISSN: 2210-7401 ISO Abbreviation: Gastroenterol. Clin. Biol. Publication Date: 2010 Dec |
Date Detail:
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Created Date: 2010-12-14 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7704825 Medline TA: Gastroenterol Clin Biol Country: France |
Other Details:
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Languages: eng Pagination: 687-95 Citation Subset: IM |
Copyright Information:
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Copyright © 2010 Elsevier Masson SAS. All rights reserved. |
Affiliation:
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Department of Internal Medicine, Chugoku Rosai Hospital, Hirotagaya 1-5-1, Kure, Hiroshima 737-0193, Japan. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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