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Sergey Tselmin, Ulrich Julius, Stefan R Bornstein, Bernd Hohenstein
INTRODUCTION: Immunoadsorption (IA) is increasingly used instead of plasma exchange due to lower risk of side effects and a higher selectivity. As a consequence of the reduction of immunoglobulins (Ig), the rate of infectious complications might increase in those patients. We therefore aimed to investigate the infection rate following IA without intravenous IG (IVIG) substitution in our apheresis center, where patients do not receive IVIG on a regular basis. MATERIAL AND METHODS: We conducted a retrospective analysis of the IA treatments performed between 2010 and 2015 without IVIG substitution and collected data on patient age, diagnosis, number of IA treatments, serum levels of Ig, total protein, albumin, C-reactive protein (CRP) and infectious complications that occurred within 2 months after the IA treatment cycle...
November 2017: Atherosclerosis. Supplements
Jenny Dietze, Bernd Hohenstein, Sergey Tselmin, Ulrich Julius, Stefan R Bornstein, Stefan Beissert, Claudia Günther
BACKGROUND: Pemphigus vulgaris is a chronic autoimmune disease characterized by blisters and erosions forming in the mucous membranes and the skin. Many patients are severely impaired by pain, weight loss and increased risk of infections. The disease is mediated by specific autoantibodies directed against desmogleins that contribute to connect keratinocytes in the epidermis. Autoantibody deposition in the skin causes inflammation and intraepidermal akantholysis. The concentration of autoantibodies in serum correlates with disease activity...
November 2017: Atherosclerosis. Supplements
S Jellinghaus, C Reich, U Schatz, S Tselmin, K Ibrahim, C Pfluecke, A Schauer, S R Bornstein, B Hohenstein, R H Strasser, U Julius, D M Poitz
BACKGROUND: Monocytes can be differentiated into subpopulations depending on their expression profile of CD14 and CD16. CD16-positive monocytes are associated with coronary artery disease. Up to now, no data exist about the effect of lipoprotein apheresis (LA) on the distribution of monocyte subpopulations. METHODS: 80 patients who underwent LA at the University Hospital Dresden were included in the study. 8 out of the 80 LA patients received LA for the first time at the time point of blood analysis...
November 2017: Atherosclerosis. Supplements
U Julius, G Siegert, H Kostka, U Schatz, B Hohenstein
BACKGROUND: A total plasma exchange was the first extracorporeal method to treat patients with severe hypercholesterolemia. But in the long run it has several disadvantages. The newer lipoprotein apheresis (LA) methods claim to be more selective with respect to the removal of atherogenic lipoproteins and thus are supposed to avoid an additional protein loss. METHODS: We wanted to compare the effect of these methods on serum protein concentrations (total serum protein, albumin, proteins measured with electrophoresis, immunoglobulins, fibrinogen, transferrin, and ferritin) which were checked before and after a single LA session in 75 patients...
May 2015: Atherosclerosis. Supplements
J Dittrich-Riediger, U Schatz, B Hohenstein, U Julius
BACKGROUND: Lipoprotein apheresis and immunoadsorption methods have a firm place among therapeutic approaches in order to treat disorders of lipoprotein metabolism or anti-body induced diseases. The extracorporeal treatment is associated with adverse effects, we wanted to report the Dresden experience. METHODS: In this study we retrospectively analyzed the adverse events of several lipoprotein apheresis and immunoadsorption methods at the Apheresis Center in Dresden (Germany)...
May 2015: Atherosclerosis. Supplements
Georg Daeschlein, Sebastian Scholz, Stine Lutze, Ruediger Eming, Andreas Arnold, Hermann Haase, Michael Hertl, Michael Jünger
The purpose of the study was to investigate the clinical efficacy of repetitive IgE immunoadsorption (IA) cycles in severe atopic dermatitis (AD) with high serum IgE levels. A total of seven patients with severe AD with a history of no significant or longterm Scoring Atopic Dermatitis (SCORAD) reduction and total serum IgE levels >700 IU/mL were enrolled. The patients received one to five series of IA (Ig-Therasorb adsorber columns; Miltenyi Biotec, Teterow, Germany) each consisting of five consecutive treatments which were performed on a monthly regimen...
June 2015: Therapeutic Apheresis and Dialysis
Heiko Hickstein, Sebastian Koball, Renate Lehmann, Chris Protzel, Kathrin Stein, Steffen Mitzner, Oliver Hakenberg
BACKGROUND: A protocol for ABO-incompatible kidney transplantation with antigen specific immunoadsorption, rituximab and conventional immunosuppression has been successfully implemented in many European centers. We report an alternative method for the elimination of isoagglutinins with a number of advantages - large amount of treatable plasma, parallel removal of other rejection-inducing antibodies, long operating life, favorable cost-benefit ratio. METHOD: We report our first successfully treated case of an ABO-incompatible living donor kidney transplantation using Immunoadsorption with Ig-TheraSorb...
April 2014: Transfusion and Apheresis Science
Ulrich Julius, Sabine Fischer, Ulrike Schatz, Jens Passauer, Stefan Bornstein
We describe our experience with the performance of six lipoprotein apheresis methods (HELP, TheraSorb LDL, DALI, lipidfiltration, Liposorber D, MONET) which have been used in 68 patients. Thirty-four of them have been treated with more than one method. The calculations presented in this paper are based on laboratory data measured at the last three available apheresis sessions before the switch to another method and at the end of the observation period, respectively. With respect to the reduction of low-density lipoprotein (LDL) cholesterol, DALI and Liposorber D appeared to be the most effective lipoprotein apheresis methods, for reduction of lipoprotein(a), Liposorber D...
April 2013: Therapeutic Apheresis and Dialysis
U Schatz, B Arneth, G Siegert, D Siegels, S Fischer, U Julius, S R Bornstein
OBJECTIVES: There is evidence of iron deficiency (ID) in patients treated with lipoprotein apheresis. Aim of this study was to assess ID in apheresis patients and to study its management comparing safety and efficacy of two approved intravenous (i.v.) iron formulations. METHODS: Inclusion criteria were defined as a) serum ferritin < 300 μg/l and transferrin saturation < 20%, b) ferritin < 100 μg/l. Both iron deficient alone and ID anemic (IDA) patients were included...
January 2013: Atherosclerosis. Supplements
P Biesenbach, S Schmaldienst, J S Smolen, W H Hörl, K Derfler, G H Stummvoll
INTRODUCTION: Pathogenic autoantibodies (Abs) are a hallmark of SLE and their rapid removal is beneficial in active SLE. Immunoadsorption (IAS) is effective in removing serum levels of all classes of immunoglobulin (Ig), immune complexes (IC) and anti-dsDNA Abs and appears superior to plasmapheresis with respect to side effects. IAS can be performed with different columns, which use different ligands to bind their target. In particular, high affinity columns are in the focus of interest...
December 29, 2009: Atherosclerosis. Supplements
J Beyer-Westendorf, W Seitz, N Jabs, P Bramlage, E Kuhlisch, U Julius, S R Bornstein, S M Schellong
OBJECTIVE: Patients with the heterozygous form of familial hypercholesterolemia (FH) display an early onset of atherosclerosis due to disturbed vascular-endothelial function. Whether the improvements of endothelial function after lipid apheresis are mediated by increased NO-production or by an altered turnover of vasoconstrictors such as ET-1 is still unknown. This was the onset of the present study. METHODS: Patients with FH and advanced atherosclerosis receiving regular LDL apheresis at 1 to 3 weeks were recruited...
December 29, 2009: Atherosclerosis. Supplements
Ulrich Julius, Sergey Tselmin, Sabine Fischer, Jens Passauer, Stefan R Bornstein
The first apheresis center in former German Democratic Republic was established in Dresden November 1990 following the reunification of Germany. We here summarize the activities of this center to date. From the center's establishment until the end of July 2009 13,291 sessions of therapeutic apheresis have been performed. Four LDL apheresis methods, namely DALI, Therasorb LDL, HELP and lipidfiltration, are available and several comparative studies of these methods have been published. In addition, we have established the Therasorb IG method and two rheophoresis methods (Rheofilter SR 20; TheraSorb-Rheo Adsorber)...
December 29, 2009: Atherosclerosis. Supplements
Claudia Günther, Jörg Laske, Antje Frind, Ulrich Julius, Christiane Pfeiffer
Pemphigus vulgaris (PV) is caused by autoantibodies to desmogleins. Standard immunosuppressive therapy may be limited by concomitant diseases or ineffective.In these cases, removal of circulating antibodies by immunoadsorption can induce remission. An 87-year-old woman with PV and considerable co-morbidities suffered from extensive mucous membrane erosions and bouts of skin blistering refractory to treatment with methotrexate,as well as mycopheno-late mofetil and corticosteroids even when combined with plasmapheresis and intravenous immunoglobulin...
August 2008: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
A Ramunni, P Brescia, D Quaranta, M Plantamura, R Ria, P Coratelli
BACKGROUND: Fibrinogen is mainly responsible for determining the viscosity of whole blood. In peripheral arterial disease (PAD) the fibrinogen concentration seems to affect the microcirculation flow. AIM: To study the effects of an abrupt reduction of fibrinogen on the hemodynamics of the lower extremities and the clinical picture of patients with PAD. METHODS: Ten patients affected by various stages of PAD underwent 1 session of fibrinogen apheresis (TheraSorb, Miltenyi Biotec, Germany)...
2007: Blood Purification
O I Afanas'eva, E V Altynova, A G Boldyrev, A A Sokolov, I Yu Adamova, S N Pokrovskii
Efficiency of sorbents for LDL apheresis was compared in vitro. The sorbents based on ion-exchange interaction of the ligand with LDL (Liposorber, DALI) exhibited minimum specificity towards the eliminated component, while immunosorbents (LNP-Lipopak, LDR-TheraSorb) were most efficient. By sorption capacity, the available hemosorbents are inferior to plasmasorbents, which explains low efficiency of the therapy based on single application of hemosorbents especially in patients with consederably increased content of LDL cholesterol...
November 2006: Bulletin of Experimental Biology and Medicine
Thomas Bosch
Therapeutic apheresis is an extracorporeal blood purification method for the treatment of diseases in which pathological proteins or cells have to be eliminated. Selective plasma processing is more efficient in pathogen removal than unselective plasma exchange and does not require a substitution fluid like albumin. This overview presents the various selective devices for the treatment of plasma (plasmapheresis) and blood cells (leukocyte apheresis). Prospective randomized trials were performed for the treatment of age-related macular degeneration (Rheopheresis), sudden hearing loss (heparin-induced lipoprotein precipitation [HELP]), rheumatoid arthritis (Prosorba), dilative cardiomyopathy (Ig-Therasorb, Immunosorba), acute-on-chronic liver failure (molecular adsorbent recirculating system [MARS]), and ulcerative colitis (Cellsorba)...
December 2005: Therapeutic Apheresis and Dialysis
P Brenner, M Schmoeckel, C Wimmer, A Rucker, V Eder, S Uchita, U Brandl, M Hinz, T Felbinger, B Meiser, C Hammer, H Reichenspurner, B Reichart
INTRODUCTION: Hyperacute xenograft rejection (HXR) and acute vascular rejection (AVR) after xenotransplantation are triggered by xenoreactive antibodies (XAb) and an activated complement cascade. In a heterotopic (abdominal) xenotransplantation model we combined immunoadsorption (IA, Ig-Therasorb column) and a quadruple immunosuppressive drug therapy in recipient baboons with donor pig hearts transgenic for human decay accelerating factor (hDAF). METHODS: According to XAb titers between 6 and 14 cycles of IA were performed preoperatively in 4 recipient baboons (18...
January 2005: Transplantation Proceedings
B Habermann, K Hochmuth, L Hovy, I Scharrer, A H A Kurth
Inhibitors of factor VIII or FIX in haemophilic patients are a common and serious complication associated with an increased risk of life-threatening bleeding during elective surgery. Substitution therapy fails to be effective, therefore an alternative treatment is needed. We have performed six major elective orthopaedic interventions in four patients with haemophilia A and inhibitors. A preoperative immunadsorbant therapy with Therasorb to eliminate inhibitors was successful in four cases, but during FVIII substitution inhibitors increased on day 4 to day 6 after surgery, leading to decreasing FVIII levels...
November 2004: Haemophilia: the Official Journal of the World Federation of Hemophilia
Wolf V Dörffel, Gerd Wallukat, Yvonnne Dörffel, Stephan B Felix, Gert Baumann
OBJECTIVE: Recent studies have shown that immunoadsorption (IA) leads to improvements in left ventricular function and in functional status in selected patients with idiopathic dilated cardiomyopathy (DCM) and circulating autoantibodiesautoantibod. Most of the few studies dealing with this topic describe only short-term results. The aim of this study was to ascertain the prolonged effects of IA over a period of 3 years. MATERIALS AND METHODS: Our study included nine patients with circulating beta1-adrenoreceptor antibodies who suffered from idiopathic DCM (left ventricular ejection fraction <30%)...
December 2004: International Journal of Cardiology
Ludwig Kramer, Edith Bauer, Martin Jansen, Daniela Reiter, Kurt Derfler, Andreas Schaffer
BACKGROUND: Immunoadsorption is increasingly used to treat antibody-mediated autoimmune diseases. To prevent microbial growth during storage, reusable protein A-Sepharose gel columns are primed with ethyl mercury thiosalicylate (thiomersal, 0.1% solution) and rinsed with phosphate buffer before use. In this study, we tested the hypothesis of systemic mercury exposure in protein A immunoadsorption. METHODS: Whole blood mercury levels were measured by atomic absorption spectroscopy before and after protein A immunoadsorption (11 patients, 26 treatments), anti-IgG immunoadsorption (eight patients, 13 treatments) and LDL apheresis (DALI and Therasorb systems; nine patients, 14 treatments)...
February 2004: Nephrology, Dialysis, Transplantation
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