Abstract
We performed extracorporial immunoadsorption therapy for anti-DNA antibodies (anti-DNA) in 4 active SLE patients with nephritis. The dextran sulphate column (SL-01, Kanegafuchi chemical) introduced to remove anti-DNA from the plasma of the subjects. The mechanism underlying the process is based on the cross reactivity of the anti-DNA antibodies with dextran sulphate, which has negatively charged units. Each patient received 4 to 7 times of this treatment with 2, 500ml of treated plasma per times.
After the course of the treatments, the titers of anti-DNA in all patients were remarkably decreased. The data of creatinine clearance were improved in 2 patients, while those remained unchanged in the other 2 patients. The treatment diminished the urinary protein more rapidly than the corticosteroid therapy alone.
In two cases, the doses of predonisolone (18mg/day, and 20mg/day, respectively) didn't seem to be enough to suppress the anti-DNA production, because the effects of immunoadsorption were not sustained for more than one month. Our experiments suggest that the extracorporeal immunoadsorption therapy using SL-01 may be benificial for patients with lupus nephritis and could give us stronger effect to suppress lupus activity when moderate to large doses (more than 0.5mg/kg/day) of steroid is combined.
