文献简介

出版社:Department of Dermatology and Laboratory of Molecular Medicine

作  者:Takuro Kanekura, Noriko Yoshii,Koichi Kawahara

编  号:

关键字:Adsorption apheresis, Allergic vasculitis, Neutrophils.

年  份:2006   点击量:861

文献摘要

Abstract:

摘要:

Cutaneous allergic vasculitis (CAV) is characterized clinically by purpuric patches with secondary ulcerations, and histologically by leukocytoclastic vasculitis with neutrophil infiltrates. Granulocyte and monocyte adsorption apheresis (GCAP) is an extracorporeal apheresis instrument using a column containing cellulose acetate beads designed to remove pathogenic granulocytes. Here we report our assessment of the efficacy of GCAP for recurrent leg ulcers in a 49-year-old woman with CAV. She underwent five GCAP treatments at one-week intervals. In each treatment session, 1800 mL of blood was processed. Her leg ulcers responded well and her white blood cell and neutrophil counts and the expression level of CD11b/ CD18, a marker for activated neutrophils were reduced from 7500/μL to 6500/μL, 4350/μL to 3315/μL, and 64.9 MFI (mean fluorescence intensity) to 27.0 MFI (normal controls: 10.5 ± 1.2 MFI) by GCAP, respectively. These results suggest that GCAP is useful for skin disorders with leucocytoclastic vasculitis.

变应性皮肤血管炎(CAV)在临床上以紫癜性斑块伴随继发性溃疡为特征,组织学上以白细胞破碎性血管炎伴有中性粒细胞浸润为特征。粒细胞和单核细胞吸附血浆分离置换法(GCAP)是一种体外血浆分离置换仪器,通过一根含醋酸纤维素珠状物的柱子,从而达到除去致病性粒细胞的目的。这里我们报道了应用GCAP疗法治疗一名49岁下肢伴有复发性溃疡的CAV患者,并对其疗效进行评估。患者每隔一周接受5GCAP治疗。在每个治疗阶段,需要处理1800毫升的血液。通过GCAP治疗后,患者腿部溃疡明显好转,白细胞和中性粒细胞计数以及CD11b/ CD18的表达水平(中性粒细胞激活的一个标志物)分别从7500/μL减少到6500/μL4350/μL减少到3315/μL64.9 MFI(平均荧光强度)减少到27.0 MFI(正常对照组:10.5±1.2 MFI)。这些结果表明,GCAP对于白细胞碎裂性血管炎的皮肤病的治疗是有效的。