高剂量白细胞去除疗法治疗难治性哮喘的安全性和有效性
2014/10/16
摘要
目标和设计：一项开放标签、非随机、单臂研究，旨在探讨高剂量白细胞去除疗法（脉冲LCAP）治疗难治性哮喘的安全性和有效性。
人群：研究纳入6例符合ATS标准的难治性哮喘患者，所有患者完成此项临床研究。
治疗： 经过4周观察，使用大LCAP滤波器脉冲LCAP，Cellsorba®CS-180S，每个疗程使用5升目标剂量，每间隔1周进行两次。
方法： 通过每日监测呼气峰流速（PEFR）两次评估临床反应。研究使用哮喘控制测试（ACT）评估哮喘症状的状态。使用化学发光分析仪测量呼出气一氧化氮（FeNO）水平，FeNO可作为嗜酸粒细胞性气道炎症的生物标志物。
结果： 早晨或傍晚的PEFR以及ACT的总和成绩在连续两次脉冲LCAP后均升高。脉冲LCAP后FeNO水平下降。
结论： 结果表明脉冲LCAP可以有效治疗难治性哮喘。
（苏楠 审校）
Inflamm Res. 2014 Jul 8. [Epub ahead of print]
Safety and efficacy of high-dose leukocytapheresis in patients with refractory asthma.
Ishizuka T1, Hisada T, Hatori M, Koike A, Hanabuchi K, Matsuzaki S, Kamide Y, Utsugi M, Aoki H, Yoshino R, Yanagitani N, Koga Y, Ono A, Kaira K, Sunaga N, Dobashi K, Tsuburai T, Akiyama K, Yamada M, Suzuki K, Mori M.
ABSTRACT
OBJECTIVE AND DESIGN: An open-label, non-randomized, single-arm study was performed to investigate the safety and efficacy of high-dose leukocytapheresis (pulse LCAP) for refractory asthma.
SUBJECTS: Six patients who fulfilled the ATS workshop criteria for refractory asthma were enrolled and completed this clinical study.
TREATMENT: After 4 weeks of observation, pulse LCAP using a large LCAP filter, Cellsorba® CS-180S, was performed twice with a 1-week interval at a target dose of 5 L per treatment session.
METHODS: The clinical response was assessed by monitoring the peak expiratory flow rate (PEFR) twice a day. The asthma control test (ACT) was used to evaluate the condition of asthma symptoms. The fraction of exhaled nitric oxide (FeNO) as a biomarker for eosinophilic airway inflammation was measured using a chemiluminescence analyzer.
RESULTS: PEFR in the morning or the evening and the sum total of the score on the ACT were increased after two consecutive sessions of pulse LCAP. FeNO decreased after pulse LCAP.
CONCLUSIONS: The results suggest the efficacy of pulse LCAP for refractory asthma.
Inflamm Res. 2014 Jul 8. [Epub ahead of print]
