T. Ayabe et al., A PILOT-STUDY OF CENTRIFUGAL LEUKOCYTE APHERESIS FOR CORTICOSTEROID-RESISTANT ACTIVE ULCERATIVE-COLITIS, Internal medicine, 36(5), 1997, pp. 322-326
Corticosteroids are effective in bringing about a clinical remission i
n patients with ulcerative colitis, However, in severely relapsed case
s, corticosteroids are not always effective even when a high dosage is
administered, In addition, the long-term use of corticosteroids often
causes serious side effects, Therefore, an alternative treatment for
active ulcerative colitis is necessary in order to avoid these clinica
l problems, In the present pilot study, the efficacy of leukocytaphere
sis using a centrifugal procedure was evaluated for corticosteroid-res
istant, active ulcerative colitis, Fourteen patients with corticostero
id-resistant severely active ulcerative colitis were treated by leukoc
ytapheresis. Thirteen patients (92.9 %) achieved clinical remission wi
thin 4 weeks after the apheresis, and remained in remission for 8 mont
hs on average without any additional corticosteroid therapy, In the re
maining patient, in whom remission was not induced, a total colectomy
was performed immediately after the fourth course of leukocytapheresis
, No significant side effects were noticed throughout the therapy, Bot
h colonoscopic and histological examinations confirmed the beneficial
effect of this procedure in terms of the reduction of severe inflammat
ion of the affected colon, We found that the expression of two adhesio
n molecules, L-selectin and VLA4a, on the surface of peripheral leukoc
ytes was decreased after this new therapy.