Granulocyte and monocyte adsorptive apheresis for pyoderma gangrenosum
Granulocyte and monocyte adsorptive apheresis for pyoderma gangrenosum
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DOI：
10.1111/1744-9987.13720
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发表时间：
2021-08-17
影响因子：
1.9
通讯作者：
Kanekura, Takuro
中科院分区：
文献类型：
--
作者：
Higashi, Yuko;Ibusuki, Atsuko;Kanekura, Takuro
坏疽性脓皮病（PG）是一种慢性无菌性炎症性皮肤病，其特征是皮肤溃疡，边界升高和破坏，对传统治疗具有耐药性。PG是由活化的中性粒细胞和巨噬细胞引起的，通常与全身性疾病有关，如炎症性肠病、类风湿关节炎、主动脉炎综合征和造血功能障碍。这项单中心研究评估了选择性消耗髓系白细胞对PG患者的有效性和安全性。年龄在20岁或以上的PG患者接受5或10次粒细胞和单核细胞吸附分离（GMA）治疗，每周一次或两次。根据皮肤溃疡的减少率、疼痛的视觉模拟量表和医生对皮肤病变的整体评估来评估治疗效果。8例患者获得完全缓解（CR）， 3例患者获得接近完全缓解（nCR）， 2例患者获得部分缓解（PR）。在其他6例中，4例病情保持稳定（SD）， 2例观察到疾病进展（PD）。无严重不良事件记录。我们的结果表明，GMA是一种有效和安全的治疗PG的方式。
Pyoderma gangrenosum (PG), a chronic aseptic inflammatory skin disease characterized by skin ulcers with elevated and undermined borders, is resistant to conventional therapies. PG is elicited by activated neutrophils and macrophages and is often associated with systemic diseases such as inflammatory bowel disease, rheumatoid arthritis, aortitis syndrome, and hematopoietic disorders. This single-center study assessed the efficacy and safety of selectively depleting myeloid-lineage leukocytes in patients with PG. Patients with PG, aged 20 or over, received 5 or 10 treatment sessions of granulocyte and monocyte adsorption apheresis (GMA), once or twice a week. Treatment efficacy was assessed based on the rate of skin ulcer reduction, the visual analog scale of pain, and the physician's global assessment of the skin lesions. A complete response (CR) was obtained in eight patients, a nearly complete response (nCR) in three patients, and a partial response (PR) in two patients. In four of the other six, the disease remained stable (SD) and in two we observed disease progression (PD). No severe adverse events were recorded. Our results suggest that GMA is a useful and safe treatment modality for PG.