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Immunoadsorption and plasma exchange in multiple sclerosis: complement and plasma protein behaviour.

M Palm1, E Behm, E Schmitt

  • 1Department of Internal Medicine, Wilhelm-Pieck-University Rostock, GDR.

Biomaterials, Artificial Cells, and Immobilization Biotechnology : Official Journal of the International Society for Artificial Cells and Immobilization Biotechnology
|January 1, 1991
PubMed
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Therapeutic plasma exchange (TPE) and immunoadsorption (IA) significantly improved multiple sclerosis (MS) patients with acute attacks, unlike steroid treatment. These procedures reduced complement pathways, potentially offering an anti-inflammatory effect for MS symptom relief.

Area of Science:

  • Neurology
  • Immunology
  • Biochemistry

Background:

  • Multiple Sclerosis (MS) is a progressive neurological disease.
  • Acute attacks and progressive forms of MS require effective treatment strategies.
  • Current treatments, including steroids, show limited efficacy in some MS patients.

Purpose of the Study:

  • To investigate the clinical efficacy of therapeutic plasma exchange (TPE) and immunoadsorption (IA) in patients with acute multiple sclerosis (MS) attacks.
  • To evaluate the impact of TPE and IA on plasma protein levels and complement pathway activity.
  • To explore the potential anti-inflammatory mechanisms of TPE and IA in MS treatment.

Main Methods:

  • A study involving three groups of patients with acute or progressive multiple sclerosis (MS).

Related Experiment Videos

  • Treatment groups received either therapeutic plasma exchange (TPE), immunoadsorption (IA), or steroids (control).
  • Plasma protein levels (IgG, IgM, IgA, fibrinogen) and total hemolytic capacities (THC) of complement pathways (CP, AP) were measured.

    • Main Results:

    • Remarkable clinical improvements were observed in MS patients with acute attacks treated with TPE and IA.
    • Steroid-treated control groups showed only slight or no improvement.
    • TPE significantly reduced plasma proteins and complement pathways; IA showed moderate protein reduction but similar complement pathway behavior and THC decreases as TPE.
    • THC decreases in TPE and IA groups are attributed to the removal/adsorption of complement factors.

    Conclusions:

    • TPE and IA demonstrate significant clinical benefits for patients experiencing acute MS attacks.
    • The reduction in complement pathways and total hemolytic capacity by TPE and IA may contribute to an anti-inflammatory effect.
    • These findings suggest TPE and IA as promising therapeutic options for managing acute MS exacerbations.