Double filtration plasmapheresis benefits myasthenia gravis patients through an immunomodulatory action

作者：Zhang, Lei; Liu, Junfeng; Wang, Hongna; Zhao, Chongbo; Lu, Jiahong; Xue, Jun^*; Gu, Yong; Hao, Chuanming; Lin, Shanyan; Lv, Chuanzheng

来源：Journal of Clinical Neuroscience, 2014, 21(9): 1570-1574.

DOI：10.1016/j.jocn.2013.11.046

• Cytokines
• Double-filtration plasmapheresis
• Myasthenia gravis
• Regulatory T cells
• Titin-antibody

Double filtration plasmapheresis (DFPP) is used to treat myasthenia gravis (MG). However, the definite mechanism is unclear. This study investigated whether DFPP improves MG through an immunomodulatory action. Thirty-five MG patients were randomly divided into two treatment groups: Group A (DFPP combined with oral methylprednisolone) and Group B (oral methylprednisolone alone). Their antibody levels, clinical scores, cytokine levels, and CD4(+)CD25(high)Foxp3(+) (regulatory T cell [Treg]) levels were then determined. Anti-titin antibody levels were significantly lower in Group A compared with Group B after treatment. The clinical remission rate in Group A was significantly higher than in Group B. The changes in cytokine levels (interleukin [IL]-2, IL-4, IL-10, and interferon-gamma) in sera and the peripheral blood mononuclear cell culture supernatants did not significantly differ before and after the treatments in both groups (p < 0.05). The soluble intercellular adhesion molecule-1 (sICAM-1) levels were lower in Group A than in Group B (p < 0.05). MG patients exhibited a lower percentage of Treg cells than normal patients. DFPP combined with methylprednisolone treatment increased the Treg cell percentage more than treatment with methylprednisolone alone (p < 0.05). DFPP treatment more effectively lowers sICAM-1 and increases Treg cell expression, consequently benefiting MG patients.

• 出版日期2014-9
• 单位复旦大学