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• W99601948 abstract "Table 1 summarizes some potentially beneficial actions of plasmapheresis. Plasmapheresis is often employed to rapidly lower circulating titers of autoantibodies (e.g., anti-glomerular basement membrane disease) or immune complexes (e.g., lupus nephritis) [ [46] Shumak K.H Rock G.A Therapeutic plasma exchange. N Engl J Med. 1984; 310: 762-771 Crossref PubMed Scopus (203) Google Scholar ]. Plasmapheresis has also been proposed as a useful adjunct to chemotherapy for removing circulating immunoglobulins or immunoglobulin components in multiple myeloma and other dysproteinemias [ [51] Wahlin A Lofvenberg E Holm J Improved survival in multiple myeloma with renal failure. Acta Med Scand. 1987; 221: 205-209 Crossref PubMed Scopus (31) Google Scholar ]. Other potential indications include the removal of components other than immunoglobulins. The removal of thrombotic factors has been suggested to explain the effect of plasmapheresis in thrombotic thrombocytopenic purpura (TTP) [ [25] Kelton J.G Neame P.B Walker I Thrombotic thrombocytopenic purpura: mechanism for effectiveness of plasmapheresis. Clin Res. 1979; 27: 299A Google Scholar ]. Plasmapheresis has also been used to decrease circulating levels of other putative toxic mediators such as bacterial toxins and inflammatory mediators in the treatment of sepsis and multiorgan failure [ [48] Stegmayr B.G Plasmapheresis in severe sepsis or septic shock. Blood Purif. 1996; 14: 94-101 Crossref PubMed Scopus (60) Google Scholar ]. Infusion of normal plasma may itself have beneficial effects. Indeed, there is evidence that replacement of a deficient plasma component may be the principal mechanism of action of plasmapheresis in TTP [ [7] Byrnes J.J Khurana M Treatment of thrombotic thrombocytopenic purpura with plasma. N Engl J Med. 1977; 297: 1386-1389 Crossref PubMed Scopus (280) Google Scholar ]. Other theoretical beneficial effects on immune function include depletion of complement products, fibrinogen, and some cytokines, alterations in idiotypic/anti-idiotypic antibody balance, and improvement in reticulo-endothelial system function [ 9 Bystryn J.C Graf M.W Uhr J.W Regulation of antibody formation by serum antibody. Removal of specific antibody by means of exchange transfusion. J Exp Med. 1970; 132: 1279-1287 Crossref PubMed Scopus (127) Google Scholar , 29 Lockwood C.M Worlledge S Nicholas A Cotton C Peters D.K Reversal of impaired splenic function in patients with nephritis or vasculitis (or both) by plasma exchange. N Engl J Med. 1979; 300: 524-530 Crossref PubMed Scopus (252) Google Scholar , 30 Low A Hotze A Krapf F Schranz W Manger B.J Mahlstedt J et al. The non specific clearance function of the reticuloendothelial system in patients with immune complex mediated diseases before and after therapeutic plasmapheresis. Rheumatol Int. 1985; 5: 69-72 Crossref PubMed Scopus (20) Google Scholar ]. Table 1Possible mechanisms of action of plasmapheresis Mechanism Example of disease Removal of circulating pathological factors Antibodies Anti-GBM antibody disease Immune complexes Lupus nephritis Cryoglobulin Cryoglobulinemia Myeloma protein Myeloma cast nephropathy Prothrombotic factor HUS-TTP Bacterial endotoxins Sepsis Poison or drug overdose Methylparathion poisoning Replacement of deficient plasma factors Antithrombotic or fibrinolytic factor HUS-TTP Effects on the immune system Removal of cytokines Sepsis Removal of complement products Lupus nephritis Effect on immune regulation Transplantation Improvement in reticuloendothelial system function Cryoglobulinemia Anti-GBM antibody disease=anti-glomerular basement membrane antibody disease; HUS-TTP=hemolytic uremic syndrome-thrombotic thrombocytopenic purpura. Adapted from Madore F, Lazarus JM, Brady HR. Therapeutic plasma exchange in renal diseases. J Am Soc Nephrol 1996;7:367–386; with permission. Open table in a new tab Anti-GBM antibody disease=anti-glomerular basement membrane antibody disease; HUS-TTP=hemolytic uremic syndrome-thrombotic thrombocytopenic purpura. Adapted from Madore F, Lazarus JM, Brady HR. Therapeutic plasma exchange in renal diseases. J Am Soc Nephrol 1996;7:367–386; with permission." @default.
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• W99601948 date "2002-04-01" @default.
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• W99601948 title "Plasmapheresis" @default.
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• W99601948 doi "https://doi.org/10.1016/s0749-0704(01)00010-0" @default.
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