Double filtration plasmapheresis benefits myasthenia gravis patients through an immunomodulatory action
Double filtration plasmapheresis benefits myasthenia gravis patients through an immunomodulatory action
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双重过滤血浆置换术通过免疫调节作用使重症肌无力患者受益
DOI：
10.1016/j.jocn.2013.11.046
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发表时间：
2014-09
影响因子：
2
通讯作者：
Lv, Chuanzheng
中科院分区：
文献类型：
--
作者：
Gu, Yong;Hao, Chuanming;Lin, Shanyan;Lv, Chuanzheng
双重滤过血浆置换（DFPP）用于治疗重症肌无力（MG）。然而，确切的机制尚不清楚。本研究调查了DFPP是否通过免疫调节作用改善MG。将35例MG患者随机分为两组：A组（DFPP联合口服甲基强的松龙）和B组（单用甲基强的松龙）。然后测定其抗体水平、临床评分、细胞因子水平和CD 4 + CD 25 highFoxp 3+（调节性T细胞[Treg]）水平。治疗后A组抗肌联蛋白抗体水平明显低于B组。A组临床缓解率明显高于B组。两组治疗前后血清及外周血单个核细胞培养上清中细胞因子（IL-2、IL-4、IL-10和IFN-γ）水平的变化无显著性差异（p< 0.05）。A组血清可溶性细胞间粘附分子-1（sICAM-1）水平低于B组（p< 0.05）。MG患者的Treg细胞百分比低于正常患者。DFPP联合甲泼尼龙治疗较单用甲泼尼龙治疗更能增加Treg细胞百分比（p< 0.05）。DFPP治疗更有效地降低sICAM-1和增加Treg细胞表达，从而使MG患者受益。
Double filtration plasmapheresis (DFPP) is used to treat myasthenia gravis (MG). However, the definite mechanism is unclear. This study investigated whether DFPP improves MG through an immunomodulatory action. Thirty-five MG patients were randomly divided into two treatment groups: Group A (DFPP combined with oral methylprednisolone) and Group B (oral methylprednisolone alone). Their antibody levels, clinical scores, cytokine levels, and CD4+CD25highFoxp3+(regulatory T cell [Treg]) levels were then determined. Anti-titin antibody levels were significantly lower in Group A compared with Group B after treatment. The clinical remission rate in Group A was significantly higher than in Group B. The changes in cytokine levels (interleukin [IL]-2, IL-4, IL-10, and interferon-γ) in sera and the peripheral blood mononuclear cell culture supernatants did not significantly differ before and after the treatments in both groups (p< 0.05). The soluble intercellular adhesion molecule-1 (sICAM-1) levels were lower in Group A than in Group B (p< 0.05). MG patients exhibited a lower percentage of Treg cells than normal patients. DFPP combined with methylprednisolone treatment increased the Treg cell percentage more than treatment with methylprednisolone alone (p< 0.05). DFPP treatment more effectively lowers sICAM-1 and increases Treg cell expression, consequently benefiting MG patients.
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DOI：
10.1046/j.1526-0968.2001.00386.x
发表时间：
2001-12-01
期刊：
THERAPEUTIC APHERESIS
影响因子：
--
作者：
Goto, H;Matsuo, H;Shibuya, N
通讯作者：
Shibuya, N
DOI：
10.4049/jimmunol.1100646
发表时间：
2011-05-01
期刊：
Journal of immunology (Baltimore, Md. : 1950)
影响因子：
--
作者：
Long EO
通讯作者：
Long EO
影响因子：
4.4
作者：
Ying Zhang;Hua-bing Wang;L. Chi;Wei-zhi Wang
通讯作者：
Ying Zhang;Hua-bing Wang;L. Chi;Wei-zhi Wang
影响因子：
3.5
作者：
G. Skeie;Å. Mygland;J. Aarli;N. Gilhus
通讯作者：
G. Skeie;Å. Mygland;J. Aarli;N. Gilhus
影响因子：
8.6
作者：
Li, Xiang;Xiao, Bao-Guo;Lu, Jia-Hong
通讯作者：
Lu, Jia-Hong