Improved white blood cell functions: additional effects of membrane plasmapheresis

The changes in cellular functions were analyzed in 4 rheumatoid arthritis and 2 biliary cirrhosis patients. Impaired T-cell functions (low lymphocyte transformation reactivity (LTR) to Con A), seen in one cirrhosis patient before MP, improved with MP. MP also removed inhibitory factor(s) for LTR from the plasma of this patient. RA patients tended to have decreased Con A response and enhanced PWM response. MP enhanced LTR in 2 patients, but lowered LTR in patient who had been taking immunosuppressive drugs. Changes in lymphocyte populations occurred and included a substantial increase of T cells. A primary effect was an increase of helper T-cells. During MP, early leukopenia accompanied by complement activation and secondary leukocytosis were observed. Phagocytic PMNs activated by this process had significant augmentation of their O-2 generating activity as measured by chemiluminescence. This was evident in severe RA and in 2 cirrhosis patients with low phagocytic cell function before MP. This activation of phagocytes by MP may lead to additional beneficial effects by further lowering MMs such as immune complexes from plasma. A better understanding of these phenomena is necessary to assess the overall therapeutic response to MP, especially in patients where cellular mechanisms are important in pathogenesis of their disease.