Development of Adsorbent for Anti-Phospholipid Antibodies and These Clinical Trials

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ELISA assay for anti-cardiolipin antibodies (anti-CL) and 1/5 Kaolin partial thromboplastin time (1/5KPTT) assay for lupus anticoagulant (LAC) were established. Anti-CL and/or LAC which were detected using above assays were significantly associated with thrombosis. fetal loss, thrombocytopenia and STS in SLE. Especially, IgG class anti-CL and above clinical findings had a strong association and all of SLE patients with LAC had IgG class anti-CL.Concerning adsorbent columns, affinity or adsorbtion capacities of anti-phospholipid antiboodies using various phospholipids, aminoacids and molecules bearing repeating negatively charged units were studied. It was found that an adsorbent column, in which dextran sulphate cellulose beads were packed, adsorbed not only anti-phospholipid antibodies but also anti-DNA antibodies effectively, and was able to be utilized as clinical use.The effect of adsorbent plasmapheresis using dextran sulphate columns on anti-DNA and/or anti-CL in 6 SLE patients. The titers of anti-DNA (RI assay), IgG anti-dsDNA (ELISA), IgG and/or IgM anti-ssDNA (ELISA), and IgG anti-CL (ELISA) significantly decreased or normalized after four treatments of plasmapheresis during a 2 to 4 week period. At the same time, rash and arthralgia disappeared. Additionally, we had an SLE patient with recurrent abortion and anti-CL/LAC who was successfully treated by adsorbent plasmapheresis. It was expected that adsorbent plasmapheresis using dextran sulphate columns would an influential treatment for patients with not only SLE having anti-phospholipid antibodies but anti-phospholipid antibodies syndrome.