Therapeutic Apheresis in Hematologic, Autoimmune and Dermatologic Diseases With Immunologic Origin.

Abstract

The process of curing a patient by removing his illness by extracting blood is a very old one. Many years ago, phlebotomy was practiced to cure illness. Now, this old process, placed on a rational basis with therapeutic apheresis (TA), is being followed in clinical practice. Therapeutic plasma exchange (TPE) with hollow fiber modules has been used in different severe diseases for more than 40 years. Based on many years of experience with the extracorporeal circulation in end-stage renal disease, the authors herein give an overview of TA in immunological diseases, especially in hematologic, autoimmune and dermatologic diseases. Updated information on immunology and molecular biology of different immunological diseases is discussed in relation to the rationale for apheresis therapy and its place in combination with other modern therapies. With the introduction of novel and effective biologic agents, TA is indicated only in severe cases, such as in rapid progression despite immunosuppressive therapy and/or biologic agents. In mild forms of autoimmune disease, treatment with immunosuppressive therapies and/or biologic agents seems to be sufficient. The prognosis of autoimmune diseases with varying organ manifestations has improved in recent years, due in part to very aggressive therapy schemes. For the immunological diseases that can be treated with TA, the guidelines of the German Working Group of Clinical Nephrology and of the Apheresis Applications Committee of the American Society for Apheresis are cited. TA has been shown to effectively remove the autoantibodies from blood and lead to rapid clinical improvement.

• Authors: Rolf Bambauer, Reinhard Latza, Daniel Burgard, Ralf Schiel
• Journal: Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy (Ther Apher Dial) Vol. 20 Issue 5 Pg. 433-452 (Oct 2016) ISSN: 1744-9987 [Electronic] Australia
• PMID: 27633388 (Publication Type: Journal Article, Review)
• Copyright: © 2016 International Society for Apheresis, Japanese Society for Apheresis, and Japanese Society for Dialysis Therapy.

Chemical References

• Autoantibodies

Topics

• Autoantibodies (blood)
• Autoimmune Diseases (therapy)
• Blood Component Removal (methods)
• Hematologic Diseases (immunology, therapy)
• Humans
• Immune System Diseases (therapy)
• Plasma Exchange (methods)
• Practice Guidelines as Topic
• Skin Diseases (immunology, therapy)