Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Viewpoint
  • Published:

Is there a role for apheresis in gastrointestinal disorders?

Nature Clinical Practice Gastroenterology & Hepatology volume 2, pages 200–201 (2005)Cite this article

APHERESIS is now a common therapeutic modality, with proven clinical benefits for several gastrointestinal disorders including inflammatory bowel disease (IBD),1 pouchitis, intestinal Bechét's disease, alcoholic hepatitis and hepatitis C. Gastroenterologists have limited experience with apheresis, however, owing to the complexity of the process.

The etiology and pathogenesis of IBD remain obscure, but it is known that immunologic factors are involved and there is consensus that the inflamed mucosa of IBD patients are infiltrated by large numbers of inflammatory cells. The treatment of IBD with leukocyte apheresis is based on the hypothesis that removal of the circulating cells involved in intestinal inflammation will re-establish the balance between uncontrolled and controlled mucosal inflammation. The efficacy of leukocyte apheresis might not be restricted to cell removal, however, as contact activation of cells with the treatment apparatus or a change in proportions of regulatory T cells might also have immunomodulatory effects.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

References

  1. Takazoe M et al. (2002) The present status and the recent development of the treatment for inflammatory bowel diseases: desirable effect of extracorporeal immunomodulation. Ther Apher 6: 305–311

    Article  CAS  Google Scholar 

  2. Holdstock GE et al. (1979) Plasmapheresis in Crohn's disease. Digestion 19: 197–201

    Article  CAS  Google Scholar 

  3. Bicks RO and Groshart KD (1989) The current status of T-lymphocyte apheresis (TLA) treatment of Crohn's disease. J Clin Gastroenterol 11: 136–138

    Article  CAS  Google Scholar 

  4. Lerebours E et al. (1994) Treatment of Crohn's disease by lymphocyte apheresis: a randomized controlled trial. Groupe d'Etudes Therapeutiques des Affections Inflammatoires Digestives Gastroenterology 107: 357–361

    Article  CAS  Google Scholar 

  5. Fukuda Y et al. (2004) Adsorptive granulocyte and monocyte apheresis for refractory Crohn's disease: an open multicenter prospective study. J Gastroenteol 39: 1158–1164

    Article  Google Scholar 

  6. Simoyama T et al. (1999) Granulocyte and monocyte apheresis with the G-1 column in the treatment of patients with active ulcerative colitis (Abstract). Jpn J Apheresis 18: 117–131

    Google Scholar 

  7. Sawada K et al. (2003) Multicenter randomized controlled trial for the treatment of ulcerative colitis with a leukocytapheresis column. Curr Pharm Des 9: 307–321

    Article  CAS  Google Scholar 

  8. Sawada K et al. Leukocytapheresis in Ulcerative Colitis: Results of a Multicenter Double-blind Prospective Case-control Study with Sham Apheresis as Placebo Treatment. Am J Gastroenterol, in press

  9. Suzuki Y et al. (2004) Selective granulocyte and monocyte adsorptive apheresis as a first-line treatment for steroid naive patients with active ulcerative colitis: a prospective uncontrolled study. Dig Dis Sci 49: 565–571

    Article  CAS  Google Scholar 

  10. Naganuma M et al. (2004) Granulocytapheresis is useful as an alternative therapy in patients with steroid-refractory or -dependent ulcerative colitis. Inflamm Bowel Dis 10: 251–257

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Inflammatory Bowel Disease Center,

    Toshifumi Hibi & Atsushi Sakuraba

  2. Inflammatory Bowel Disease Center of Keio University, Japan

    Toshifumi Hibi & Atsushi Sakuraba

Authors
  1. Toshifumi Hibi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Atsushi Sakuraba
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Toshifumi Hibi.

Ethics declarations

Competing interests

The authors declare no competing financial interests.

Supplementary information

Glossary

APHERESIS

The removal of blood from the body and withdrawal of a specific component. Blood is retransfused to the body once the process is complete

Rights and permissions

Reprints and permissions

About this article

Cite this article

Hibi, T., Sakuraba, A. Is there a role for apheresis in gastrointestinal disorders?. Nat Rev Gastroenterol Hepatol 2, 200–201 (2005). https://doi.org/10.1038/ncpgasthep0168

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1038/ncpgasthep0168

This article is cited by

Search

Advanced search

Quick links

Nature Briefing

Sign up for the Nature Briefing newsletter — what matters in science, free to your inbox daily.

Get the most important science stories of the day, free in your inbox. Sign up for Nature Briefing