Immunoadsorption therapy in patients with multiple sclerosis with steroid-refractory optical neuritis

• Published in: Journal of neuroinflammation 2012-04, Vol.9 (1), p.80-80, Article 80
• Main Authors: Koziolek, Michael J, Tampe, Desiree, Bähr, Matthias, Dihazi, Hassan, Jung, Klaus, Fitzner, Dirk, Klingel, Reinhard, Müller, Gerhard A, Kitze, Bernd
• Format: Article
• Language: English
• Subjects: Acquisitions & mergers; Adrenal Cortex Hormones - administration & dosage; Adrenal Cortex Hormones - therapeutic use; Adult; Apheresis; Autoimmune diseases; Care and treatment; Corticosteroids; Cytokines; Evoked Potentials, Visual - drug effects; Evoked Potentials, Visual - immunology; Evoked potentials/visual; Female; Follow-Up Studies; Health aspects; Humans; Immunoadsorption; Immunoglobulins; Immunosorbent Techniques - trends; Inflammation; Interleukins; Male; Medical statistics; Middle Aged; Molecular weight; Multiple sclerosis; Multiple Sclerosis - drug therapy; Multiple Sclerosis - epidemiology; Multiple Sclerosis - immunology; Myelin proteins; Nerves; Optic neuritis; Optic Neuritis - drug therapy; Optic Neuritis - epidemiology; Optic Neuritis - immunology; Physiological aspects; Plasma; Platelet Transfusion; Polyvinyl alcohol; Prospective Studies; Protein binding; Proteins; Proteomics; Rheumatology; Tryptophan; Tryptophan - administration & dosage; Tryptophan - therapeutic use; Young Adult
• ISSN: 1742-2094; 1742-2094
• DOI: 10.1186/1742-2094-9-80

In multiple sclerosis relapses refractory to intravenous corticosteroid therapy, plasma exchange is recommended. Immunoadsorption (IA) is regarded as an alternative therapy, but its efficacy and putative mechanism of action still needs to be established. We prospectively treated 11 patients with multiple sclerosis who had optical neuritis and fulfilled the indications for apheresis therapy (Trial registration DE/CA25/00007080-00). In total, five IA treatments were performed using tryptophan-IA. Clinical activity (visual acuity, Expanded Disability Status Scale, Incapacity Status Scale), laboratory values and visual evoked potentials were measured before, during and after IA, with a follow-up of six months. Moreover, proteomic analyses were performed to analyze column-bound proteins as well as corresponding changes in patients' sera. After the third IA, we detected an improvement of vision in eight of eleven patients, whom we termed responders. Amongst these, the mean visual acuity improved from 0.15 ± 0.12 at baseline to 0.47 ± 0.32 after the third IA (P = 0.0252) up to 0.89 ± 0.15 (P