Recambio plasmático en las enfermedades autoinmunes sistémicas

Seminarios de la Fundación Espa?ola de Reumatología Pub Date : 2013-04-01 DOI:10.1016/j.semreu.2013.02.002

Guillermo J. Pons-Estel , Rosa Serrano , Miguel Lozano , Joan Cid , Ricard Cervera , Gerard Espinosa

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引用次数: 8

Abstract

Therapeutic apheresis encompasses a large number of techniques whose main purpose is to process patients’ blood through an extracorporeal device. The aim is to remove antibodies and preformed immune complex to avoid tissue damage, eliminate inflammatory mediators – such as complement and cytokines, which could contribute to further damage – restore deficiencies, and stimulate lymphocyte clones to improve the response to immunosuppressive therapy.

Among the different types of apheresis, the most commonly used for the treatment of autoimmune diseases are plasma exchange and immunoadsorption.

To aid the correct use of these procedures, the American Society for Apheresis has established more than 65 indications classified into different categories according to the level of evidence. In this review, we analyze the distinct therapeutic indications for the treatment of different autoimmune diseases.

This review indicates that plasma exchange is a safe and effective therapeutic option for treating the serious manifestations of systemic autoimmune diseases and is a valid option for those patients with diseases refractory to conventional treatments.

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全身自身免疫性疾病的血浆置换

治疗性血液分离包括大量的技术，其主要目的是通过体外装置处理患者的血液。其目的是去除抗体和预先形成的免疫复合物以避免组织损伤，消除炎症介质(如补体和细胞因子，它们可能导致进一步的损伤)，恢复缺陷，并刺激淋巴细胞克隆以改善对免疫抑制治疗的反应。在不同类型的血液分离中，最常用于自身免疫性疾病治疗的是血浆交换和免疫吸附。为了帮助正确使用这些程序，美国采血学会根据证据水平建立了超过65种适应症，分为不同的类别。在这篇综述中，我们分析了治疗不同自身免疫性疾病的不同适应症。这一综述表明血浆置换是一种安全有效的治疗方案，可用于治疗系统性自身免疫性疾病的严重表现，对于那些常规治疗难治性疾病的患者是一种有效的选择。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Seminarios de la Fundación Espa?ola de Reumatología

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