Article Text

Download PDFPDF
Leukoapheresis in Crohn's disease: the final curtain?
  1. Laurent Peyrin-Biroulet1,
  2. Silvio Danese2
  1. 1Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy, Vandoeuvre-lès-Nancy, France
  2. 2IBD Center, Division of Gastroenterology, IRCCS Istituto Clinico Humanitas, Rozzano, Milan, Italy
  1. Correspondence to Dr Laurent Peyrin-Biroulet, Inserm U954 and Department of Hepato-Gastroenterology, University Hospital of Nancy-Brabois, Allée du Morvan, Vandoeuvre-lès-Nancy 54511, France; peyrinbiroulet{at}gmail.com

Statistics from Altmetric.com

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

In 2012, our therapeutic armamentarium is still limited in patients with Crohn's disease (CD) refractory to standard medications. Anti-tumor necrosis factor (TNF) agents (eg, infliximab and adalimumab) have changed the way these patients are treated. However, only one third of patients with CD who are administered infliximab or adalimumab will be in clinical remission at 1 year.1 In addition, secondary loss of response is relatively frequent with all anti-TNF agents.2 New therapeutic options are therefore eagerly awaited for these patients. With this in mind, the relative newcomer apheresis looked promising.

Cytapheresis or depletion of activated granulocytes and monocytes/macrophages from the circulation could theoretically reduce leukocyte-dependent inflammation in immune-mediated disorders such as the inflammatory bowel diseases (IBD). One mechanism through which this can be achieved is using the medical device Adacolumn, an extracorporeal circulatory system with a G-1 column (Otsuka Pharmaceutical Europe Ltd., Middlesex, UK) that mediates selective cytapheresis of activated granulocytes and monocytes/macrophages from venous blood. The column contains cellulose acetate beads (2 mm in diameter) that act as carriers to selectively adsorb granulocytes and monocytes/macrophages, but only a much more limited number of lymphocytes.

The column is initially bathed in sterile saline, but once blood is added and comes into contact with the cellulose acetate beads, adhesion and absorption of peripheral blood cells begins. Immune complexes (IC) and …

View Full Text

Footnotes

  • Contributors Both authors: editing of the manuscript.

  • Competing interests LPB and SD, consulting and lecture fees from MERCK and Abbott.

  • Provenance and peer review Commissioned; internally peer reviewed.