The low-throughput protein A adsorber: an immune modulatory device. Hypothesis for the mechanism of action in the treatment of rheumatoid arthritis.
Mod Rheumatol
; 15(1): 9-18, 2005.
Article
en En
| MEDLINE
| ID: mdl-17028816
To achieve specific removal of pathogenic antibodies (Ab) or immune complexes (IC), several adsorbers have been developed. We discuss the mode of action of low-throughput staphylococcal protein A (SPA) immunoadsorption. The SPA-based Prosorba apheresis is likely to modify some of the autoantibodies (autoAb) or IC. The low-throughput adsorber showed very limited adsorption capacity of circulating autoAb and/or circulating IC. Besides changes of humoral diagnostic parameters, cellular changes could be observed in the Prosorba-treated patients. These changes were rather similar to those that have been observed in a patient successfully treated with Ab against tumor necrosis factor alpha. We propose an adsorber-catalyzed conversion of small, tissue-penetrating, scarcely detectable, non-complement-binding, proinflammatory IgG-rheumatoid factor (RF)-based IC into the more readily phagocytosed species of IC: intermediate-sized, partially cryoprecipitable, non-tissue penetrating IC that are opsonized with complement. These IC are rather short-lived and could quickly be cleared by the body's scavenging system.
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Colección:
01-internacional
Base de datos:
MEDLINE
Idioma:
En
Revista:
Mod Rheumatol
Año:
2005
Tipo del documento:
Article
País de afiliación:
Alemania
Pais de publicación:
Reino Unido