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Adsorptive granulocyte and monocyte apheresis: A potentially relevant therapeutic option for COVID-19
Takuro Kanekura1, Koichi Kawahara2
1Department of Dermatology, Kagoshima University Graduate School of Medical and Dental Sciences, 8-35-1 Sakuragaoka, Kagoshima 890-8520, Japan.
Insights
Granulocyte and monocyte apheresis (GMA) may treat severe COVID-19 by reducing inflammatory cytokines and blood clots. This extracorporeal therapy shows promise for managing COVID-19 complications, particularly in patients with co-existing conditions.
Area of Science:
- Immunology
- Hematology
- Critical Care Medicine
Background:
- Coronavirus disease 2019 (COVID-19) is associated with dangerous overproduction of proinflammatory cytokines and thromboembolism.
- Activated myeloid lineage cells contribute to the cytokine storm and thrombotic events in COVID-19.
- Granulocyte and monocyte apheresis (GMA) is an established extracorporeal therapy for ulcerative colitis, targeting activated myeloid cells.
Purpose of the Study:
- To evaluate the potential of granulocyte and monocyte apheresis (GMA) as a treatment for COVID-19.
- To explore the mechanisms by which GMA might mitigate COVID-19-related complications.
Main Methods:
- Review of previous studies on GMA's effects on proinflammatory cytokines and neutrophil-platelet aggregates.
- Analysis of a recent case report detailing GMA use in a COVID-19 patient with ulcerative colitis.
Main Results:
- GMA has been shown to decrease proinflammatory cytokines.
- GMA reduces neutrophil-platelet aggregates, a key factor in thromboembolism.
- A case report suggests potential clinical benefit of GMA in a COVID-19 patient.
Conclusions:
- The mechanisms of action of GMA align with the pathophysiology of severe COVID-19.
- GMA represents a potential therapeutic option for managing COVID-19, particularly its inflammatory and thrombotic aspects.
Abstract:
The overproduction of proinflammatory cytokines and subsequent thromboembolism are major problems of coronavirus disease 2019 (COVID-19). Adsorptive granulocyte and monocyte apheresis (GMA), used for ulcerative colitis, is an extracorporeal therapy designed to remove activated myeloid lineage cells. Previous studies have demonstrated that GMA decreases proinflammatory cytokines and neutrophil-platelet aggregates. The effect of GMA on COVID-19 in a patient with ulcerative colitis was recently reported. The modes of action of GMA together with the findings of this case report indicate that GMA could be a relevant treatment option for COVID-19.
