REDUCTION OF PLASMA-FIBRINOGEN, IMMUNOGLOBULIN-G, AND IMMUNOGLOBULIN-M CONCENTRATIONS BY IMMUNOADSORPTION THERAPY WITH TRYPTOPHAN AND PHENYLALANINE ADSORBENTS

Immunoadsorption (IA) therapy with tryptophan (TR-350) or phenylalanin e (PH-350) adsorbents has been used to reduce the concentration of ser um antibodies in human lymphocyte antigen (HLA)-immunized patients. Ot her forms of plasma purification have been reported to reduce the leve l of fibrinogen, which affects the blood properties. In this study we investigated the effects of IA therapy using both adsorbents on plasma fibrinogen and Immunoglobulins G and M in 13 patients (8 patients wer e treated with TR-350, and 5 patients were treated with PH-350). Durin g each session 1 plasma volume (2.8 +/- 0.4 L of plasma) was processed through the immunocolumn and then returned to the patient together wi th the blood cells. Compared with the pretreatment values, the plasma fibrinogen, IgG, and IgM concentrations were significantly reduced aft er IA therapy (p < 0.01 for TR-350: p < 0.04 for PH-350). There was a positive correlation relation between the degree of reduction of plasm a proteins and the number of IA treatments given. A nonparametric test (Wilcoxon's signed-rank test or the Mann-Whitney test) was used for s tatistical analysis. We conclude from our study that IA therapy effect ively lowers the plasma levels of fibrinogen, IgG, and IgM and thus ca n be considered a valuable alternative to other blood purification met hods.