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首页> 外文期刊>Journal of clinical apheresis. >Granulomonocytapheresis as a cell-dependent treatment option for patients with inflammatory bowel disease: Concepts and clinical features for better therapeutic outcomes
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Granulomonocytapheresis as a cell-dependent treatment option for patients with inflammatory bowel disease: Concepts and clinical features for better therapeutic outcomes

机译：肉芽糖粥样糖尿病作为炎症性肠病患者的细胞依赖性治疗选择：概念和临床特征，用于更好的治疗结果

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Ulcerative colitis (UC) and Crohn's disease (CD) are major phenotypes of the chronic inflammatory bowel disease (IBD), which afflicts millions of individuals throughout the world with debilitating symptoms. The chronic nature of IBD means that patients require life-long medications, and this may lead to drug dependency, loss of response together with adverse side effects as additional morbidity factors. The efficacy of antitumour necrosis factor (TNF)-alpha biologics has validated the role of inflammatory cytokines notably TNF-alpha in the exacerbation and perpetuation of IBD. However, cytokines are released by myeloid lineage leucocytes like the CD14(+)CD16(+) monocyte phenotype. Additionally in IBD, myeloid leucocytes are elevated with activation behavior, while lymphocytes are compromised. Therefore, patients' leucocytes appear logical targets of therapy. Adsorptive granulomonocytapheresis (GMA) with an Adacolumn uses carriers, which interact with the Fc gamma receptor expressing leucocytes and deplete the elevated myeloid leucocytes, while the neutrophils, which re-enter the circulation via the Adacolumn outflow (>= 40%) are phagocytosed by CD19 B-cells to become interleukin (IL)-10 producing Bregs or CD19(high)CD1D(high) B-cells. IL-10 is an anti-inflammatory cytokine. GMA has been applied to treat patients with IBD. The efficacy outcomes have been impressive as well as disappointing, the clinical response to GMA defines the patients' disease course and severity at entry. Efficacy outcomes in patients with deep ulcers together with extensive loss of the mucosal tissue are not encouraging, while patients without these features respond well and attain a favorable long-term disease course. Accordingly, for responder patients, GMA fulfills a desire to be treated without drugs.
机译：溃疡性结肠炎（UC）和CrOhn病（CD）是慢性炎症性肠病（IBD）的主要表型，其在全世界困扰着令人衰弱的症状。 IBD的慢性本质意味着患者需要终生物的药物，这可能导致药物依赖性，与额外的发病率因素的不良副作用一起丧失。抗肿瘤坏死因子（TNF） - alpha生物学的疗效验证了炎症细胞因子的作用显着下TNF-α在加剧和持续的IBD中。然而，细胞因子被髓样谱系白细胞释放，如CD14（+）CD16（+）单核细胞表型。此外，在IBD中，髓细胞胶质细胞升高，激活行为升高，而淋巴细胞受到损害。因此，患者的白细胞出现了逻辑治疗目标。具有亚替昔粒子的吸附肉芽糖细胞膜膜（GMA）使用载体与表达白细胞的Fcγ受体相互作用并耗尽升高的骨髓白细胞，而中性粒细胞通过曲棕榈油（> = 40％）重新进入循环（> = 40％）是吞噬CD19 B细胞变成白细胞介素（IL）-10，产生贫氏或CD19（高）CD1D（高）B细胞。 IL-10是一种抗炎细胞因子。 GMA已应用于治疗IBD患者。疗效结果令人印象深刻，令人失望，对GMA的临床反应定义了患者的疾病课程和进入的严重程度。患有深层溃疡的疗效结果与粘膜组织广泛丧失的患者不鼓励，而没有这些特征的患者恢复良好并获得有利的长期疾病课程。因此，对于响应者患者，GMA旨在没有药物治疗的愿望。

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