[Therapeutic Apheresis in Neurological Disorders]

Therapeutic apheresis is a valuable therapeutic option for various immune-mediated human disorders. Its therapeutic rationale is based on the removal of pathogenic autoantibodies and inflammatory molecules, such as complements, cytokines, and chemokines, that accelerate the disease activity. At the same time, other mechanisms of immune-modulatory effects have also been suggested. Therapeutic apheresis has been applied to Guillain-Barré syndrome, chronic inflammatory demyelinating polyneuropathy, myasthenia gravis, and multiple sclerosis. For neuromyelitis optica spectrum disorder (NMOSD), in which anti-aquaporin 4 antibody plays a major pathogenic role, both plasma exchange and plasma adsorption are reported to be effective. Recently, the incidence and prevalence of autoimmune encephalitis have been increasingly reported in comparison to infective encephalitis, and these often respond to therapeutic apheresis. Therapeutic apheresis for immune-mediated neurological disorders is described in this section.