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Plasmapheresis combined with interferon: an effective therapy for multiple sclerosis
R D Medenica1, S Mukerjee, K Alonso
1Cancer Immuno-Biology Laboratory, Hilton Head Island, South Carolina, USA.
Journal of Clinical Apheresis
|January 1, 1994
Summary
Interferon (IFN) therapy for multiple sclerosis (MS) can be improved by removing an interferon inhibitor factor (IIF) using plasmapheresis (PP). This combined approach enhanced immune cell function and clinical outcomes in MS patients.
Area of Science:
- Immunology
- Neuroscience
- Virology
Background:
- Multiple sclerosis (MS) pathogenesis involves an immune response in genetically susceptible individuals, potentially triggered by viral infections.
- Interferon (IFN) therapy is used for MS due to its antiviral and immunomodulatory properties.
- An interferon inhibitor factor (IIF) in patient sera can reduce the efficacy of IFN treatment for MS.
Purpose of the Study:
- To investigate the efficacy of plasmapheresis (PP) combined with interferon (IFN) therapy in treating multiple sclerosis (MS).
- To evaluate the impact of removing interferon inhibitor factor (IIF) and lymphokine inhibitor factor (LIF) on MS patient outcomes.
- To assess changes in immune cell populations following PP and IFN treatment in MS patients.
Main Methods:
- Plasmapheresis (PP) was performed on 24 MS patients receiving intermittent IFN-alpha and human leukocyte IFN.
- Interferon (IFN) levels, presence of interferon inhibitor factor (IIF), and lymphokine inhibitor factor (LIF) were monitored.
- Immune cell populations (T helper cells, T suppressor cells, HLADR antigen, NK cells, monocytes/macrophages) were analyzed by flow cytometry before and after PP.
Main Results:
- IFN levels increased significantly in 18 patients and modestly in three, correlating with clinical improvement.
- Three non-responders showed no increase in IFN levels.
- PP potentially removed IIF and LIF, explaining treatment success.
- A significant increase in immune-competent cells correlated with improved Kurtzke disability status in 13 patients; eight stabilized.
- Patients with disease progression showed no change or a decrease in these immune parameters.
Conclusions:
- Plasmapheresis (PP) combined with interferon (IFN) therapy may be an effective treatment strategy for multiple sclerosis (MS).
- Removing IIF and LIF via PP can enhance IFN therapy efficacy.
- Improvements in immune cell populations correlate with clinical recovery in MS patients undergoing PP and IFN treatment.