Abstract
To investigate the mechanism of improvements in the symptoms of rheumatoid arthritis (RA) induced by an extracorporeal granulotrap column (G-1), an ex vivo study was undertaken on peripheral blood from RA patients while being treated with the G-1. Our focus was on the modulations of granulocytes and monocytes, but also on T cell function as well during or after completion of G-1 therapy. The G-1 column selectively trapped granulocytes and monocytes from peripheral blood with a trapping efficiency of about 40%.This resulted in a decrease in inflammatory leukocytes in the systemic blood during apheresis (p<0.05, n=14) . The production of TNF-α, IL-6 and IL-8 was also significantly decreased in blood stimulated by LPS at post column by compared with pre perfusion (p<0.02, n=9) . IFN-γproduction by T cells stimulated with anti CD3 MoAb showed a modest but significant decrease during apheresis (p<0.05, n=8) . Additionally, IL-1β production capacity of mononuclear cells stimulated with LPS was strikingly suppressed in studies of 6 patients (p<0.05) after the initiation of G-1; the effect was sustained for up to 2 weeks after completion of G-1 therapy.The results suggest that the G-1 column, in addition to trapping fraction of granulocytes and monocytes, also produces extracorporeal immunomodulation.
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