Adacolumn Granulocyte-Apheresis for Alcoholic Hepatitis: Preliminary Study

Area of Science:

• Hepatology
• Immunology
• Medical Technology

Background:

• Alcoholic hepatitis (AH) involves an acute-on-chronic inflammatory response in the liver.
• White blood cells (WBCs) play a key role in AH pathogenesis and prognosis.
• Adacolumn selectively removes myeloid lineage leukocytes (granulocytes, monocytes/macrophages) to potentially improve patient outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of Adacolumn granulocyte-apheresis therapy in patients with alcoholic hepatitis.
• To assess the impact of Adacolumn apheresis on inflammatory markers, liver function tests, and clinical status.

Main Methods:

• Six patients with alcoholic hepatitis, non-responsive to corticosteroids (Maddrey Discriminant Function >32, MELD score 20-26), received Adacolumn granulocyte-apheresis.
• Treatment involved five daily 1-hour sessions over 5 consecutive days.
• Evaluations included liver parameters, WBC count, proinflammatory cytokines, coagulation, and predictive scores before and after treatment, with a 28-day follow-up.

Main Results:

• Significant reduction in WBC count (P < .014) and key proinflammatory cytokines (IL-6, TNFα, IL-8) observed post-treatment.
• Improvements noted in liver enzymes aspartate transaminase (AST; P < .02) and alanine transaminase (ALT; P < .011).
• At 28 days, prothrombin time (PT), IL-6, TNFα, AST, and ALT showed significant improvement.

Conclusions:

• Adacolumn apheresis demonstrated safety and effectiveness in improving the clinical status of AH patients.
• The therapy led to a reduction in inflammatory markers and improved liver function indicators.
• Further studies with larger patient cohorts are necessary to validate these promising findings.