Plasma exchange and immunoadsorption for autoimmune neurologic diseases - current guidelines and future perspectives

Atherosclerosis. Supplements
Reinhard KlingelCordula Fassbender

Abstract

There is increasing interest from neurologists to use therapeutic apheresis in autoimmune neurologic diseases due to growing knowledge of pathogenic relevance of autoantibodies. Developments in that field have been summarized in this review focusing on German guidelines and recent results from clinical research. Therapeutic apheresis can offer a therapeutic armamentarium with rapid response for severe acute neurologic symptoms, and a drug-free option for clinical courses being refractory to drug based strategies or complicated by drug side effects. Plasma exchange (PE) as the classical method has become part of current guidelines within basic and escalating immunomodulatory treatments of autoimmune neurologic diseases, and in daily practice gets increasingly replaced by selective immunoadsorption (IA) due to its equivalent efficacy in combination with a superior safety profile. Therapeutic effects of PE and IA in autoantibody mediated diseases can be attributed to 3 major mechanisms: immediate intravascular reduction of (auto-)antibody concentration, pulsed induction of antibody redistribution, and subsequent immunomodulatory changes. 5 treatments over a period of 8-10 days seem to be an appropriate regimen to restore neurologi...Continue Reading

References

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Citations

Apr 28, 2012·Journal of Neuroinflammation·Michael J KoziolekBernd Kitze
Jan 30, 2013·Atherosclerosis. Supplements·Franz HeiglErich Mauch
May 6, 2015·Atherosclerosis. Supplements·Johannes MühlhausenMichael J Koziolek
May 6, 2015·Atherosclerosis. Supplements·Bernd HohensteinUlrich Julius
Mar 1, 2011·Expert Opinion on Emerging Drugs·Christa WalgaardPieter A van Doorn
Jan 31, 2019·Journal of Clinical Apheresis·Mark LipphardtMichael J Koziolek
Nov 10, 2013·Journal of Infusion Nursing : the Official Publication of the Infusion Nurses Society·Norma D McNair
Jul 16, 2020·Phytotherapy Research : PTR·Haroon KhanSyed M M Shah
May 13, 2020·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Brad J KollsAlok K Sahgal
Feb 6, 2018·Therapeutic Advances in Neurological Disorders·Yong-Won ShinKon Chu
Apr 10, 2017·Acta neurologica Belgica·I SmetsUNKNOWN Belgian Study Group for Multiple Sclerosis

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