THE EFFECT OF PLASMAPHERESIS AND DEOXYSPERGUALIN OR CYCLOPHOSPHAMIDE TREATMENT ON ANTIPORCINE GAL-ALPHA(1,3)-GAL ANTIBODY-LEVELS IN HUMANS

The levels of human natural anti-porcine antibodies were followed in s ix HLA-immunized patients treated with plasmapheresis (PF) in combinat ion with either 15-deoxyspergualin (DSG) or cyclophosphamide (CYP), PF was carried out three times a week for 4 weeks, and DSG was administe red in a dose of 5 mg/kg following every third PF. CYP was given in a daily dose of 1-1.5 mg/kg. Four patients were randomized to DSG treatm ent and two were given CYP. Following the last (4th) DSG infusion, all patients continued on CYP treatment. Levels of antibodies toward porc ine thyroglobulin were measured in an ELISA assay; thyroglobulin carri es the major target for human anti-porcine natural antibodies, Gal-alp ha(1,3)-Gal determinant. In all patients there was a drop in antibody levels. However, the antibodies never disappeared. The drop was more p ronounced and more rapid in the DSG-treated group, but following the e nd of the PF series, antibody levels in both treatment groups rapidly returned to baseline or above baseline. In two patients in the DSG gro up, treatment had to be stopped because of side effects. No adverse re actions were noted in the CYP group. It is concluded that plasmapheres is in conjunction with DSC seems mon effective than CYP treatment in r educing the levels of anti-porcine Gal-alpha(1,3)-Gal antibody. Howeve r, the dose of DSG should be reduced to lower the risk of side effects .