Plasma Exchange vs. Immunoadsorption: Effects on Immunological Markers and Predictive Value in Steroid-Refractory MS...

Area of Science:

• Neuroimmunology
• Biochemistry

Background:

• Limited understanding of neurochemical mechanisms in steroid-refractory Multiple Sclerosis (MS) attacks treated with apheresis.
• Investigating apheresis efficacy in MS requires examining its impact on specific immunological parameters.

Purpose of the Study:

• To compare the effects of immunoadsorption (IA) and plasma exchange (PLEX) on serum immunological markers in MS patients.
• To determine the predictive value of these immunological markers for apheresis response in MS.

Main Methods:

• Analysis of pre- and post-procedural serum samples from 38 MS patients undergoing IA (n=19) or PLEX (n=19) from the IAPEMS trial.
• Quantification of serum immunoglobulins (IgG, IgA, IgM), immunoglobulin free light chains (κ-FLC, λ-FLC), and chemokines (CXCL13, CXCL12).

Main Results:

• Both IA and PLEX significantly reduced serum immunoglobulins (IgG, IgA, IgM) and lambda-FLC.
• IA reduced CXCL12, while PLEX increased CXCL13; IA did not affect κ-FLC, but PLEX did.
• No evaluated serum parameter predicted apheresis response in MS patients.

Conclusions:

• IA and PLEX exert differential effects on serum immunological parameters in MS.
• IA may be more effective in reducing B-cell-mediated inflammation compared to PLEX.
• Further research is needed to correlate these findings with clinical outcomes and B-cell therapy efficacy in MS.