Effect of adsorbent of Riposorber, a cellulose microparticle with immobilized dextran sulfate, on the serum...

Abstract-Apheresis. using columns of cellulose microparticles with immobilized dextran sulfate, Riposorber, has been applied to treatment of patients with various diseases, such as hypercholesterolemia and systemic lupus erythematosus. Unfortunately, it has been reported that the apheresis activates the complement system. It might exert unpleasant side effects on patients during lifelong treatment. In this study, the interaction of the serum complement system with cellulose microparticles with immobilized dextran sulfate and its components, nontreated cellulose microparticles and dextran sulfate, were examined in vitro to get some ideas for development of an extracorporeal apparatus which does not give any serious damage to patient blood. The cellulose microparticles with immobilized dextran sulfate reduces both the CH50 and the ACH50. Decrease in CH50 is not due to the classical pathway activation, but to adsorption of C2 or Cl components including Clq. The alternative pathway was not activated by the addition of the dextran sulfate alone to serum, but the addition of non-treated cellulose microparticles to serum activated complement. Form these, decrease in ACH50 is not caused by dextran sulfate on the microparticles, but by the hydroxyl groups of the cellulose microparticles that is the core of the column. For prevention of complement activation, hydroxyl groups remaining after dextran sulfate immobilization should be blocked by further treatment with a reagent that reacts with them, or else dextran sulfate might be immobilized on particles without nucleophiles such as hydroxyl or amino groups.