Granulocytapheresis in patients with refractory ocular Behcet's disease
Granulocytapheresis in patients with refractory ocular Behcet's disease
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DOI：
10.1002/jca.20076
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发表时间：
2006-07-01
影响因子：
1.5
通讯作者：
Ohno, Shigeaki
中科院分区：
文献类型：
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作者：
Namba, Kenichi;Sonoda, Koh-Hei;Ohno, Shigeaki
眼内炎症（葡萄膜视网膜炎）是白塞病（BD）的主要并发症之一，对药物治疗反应不佳。这项开放的前瞻性研究旨在评估选择性粒细胞穿刺治疗难治性双相色素性葡萄膜视网膜炎的疗效。14例患者年龄在20-56岁之间。粒细胞分离是用一个充满醋酸纤维素白细胞载体或珠的adacac柱子完成的，这些载体或珠从柱中的血液中吸附粒细胞和单核细胞。每位患者连续5周接受5次adaccolumn治疗，每次1次/周。这项研究的目的是让每个病人作为他或她自己的对照。在5次阿达科柱治疗前后监测6个月的眼部发作（OA）总数。使用adac柱前6个月的OA数（平均SD）为4.21 +/- 1.6，使用adac柱后6个月的OA数为2.93 +/- 1.39 （P = 0.0275）。9例（64%）改善，5例无变化或恶化。此外，对于病程bb0 = 5年的亚组（n = 7），前6个月OA数为4.71 +/- 1.89，后6个月OA数为2.29 +/- 1.38 （P = 0.0054）。BD病程< 5年的亚组（n = 7）对应值分别为3.71 +/- 1.25和3.57 +/- 1.13，说明病程较长的患者反应较好。我们认为粒细胞清除术治疗难治性眼性双相障碍可能是安全有效的，需要进一步的研究来充分评价粒细胞清除术治疗双相障碍的临床疗效。
Intraocular inflammation (uveoretinitis) is one major complication of Behcet's disease (BD) and responds poorly to drug therapy. This open prospective study was to assess the efficacy of selective granulocytapheresis in patients with refractory uveoretinitis of BD. Fourteen patients aged 20-56 years were treated. Granulocytapheresis was done with an Adacolumn filled with cellulose acetate leucocyte carries or beads that adsorb granulocytes and monocytes from the blood in the column. Each patient received 5 Adacolumn sessions at one session/week over 5 consecutive weeks. The study was designed to allow each patient to serve as his or her own control. The total numbers of ocular attacks (OA) were monitored for 6 months before and after 5 Adacolumn sessions. The number of OA (mean SD) per patient for the 6 months before Adacolumn was 4.21 +/- 1.6 and for the 6 months post Adacolumn was 2.93 +/- 1.39 (P = 0.0275). Nine patients (64%) improved and 5 did not change or worsened. Further, for a sub-group (n = 7) with duration of BD >= 5 years, the number of OA were 4.71 +/- 1.89 for the first 6 months and 2.29 +/- 1.38 for the second 6 months (P = 0.0054). The corresponding values for a sub-group (n = 7) with duration of BD < 5 years were 3.71 +/- 1.25 and 3.57 +/- 1.13, indicating that patients with long duration of BD are better responders. We conclude that granulocytapheresis might be effective and safe for patients with refractory ocular BD. Further studies are necessary to fully evaluate the clinical efficacy of granulocytapheresis for BD.