Abstract：
:Many rheumatological diseases are either caused by specific known proteins, such as antibodies or mediated by a plethora of cytokines. Both the unspecific immunosuppressive therapy and the specific action of biologics usually require time to be effective; therefore, extracorporeal forms of treatment are increasingly being employed in severe forms of rheumatological diseases as well as in patients who cannot tolerate pharmacological treatment or where the risk of pharmacological treatment may outweigh the potential benefits. Therapeutic plasma exchange (TPE) removes not only pathogenic substances, such as autoantibodies, lipoproteins and circulating immune complexes from the plasma but also cytokines. The removed plasma that is discarded has to be substituted by blood products, e.g. human albumin or fresh frozen plasma. Fresh frozen plasma is always used when missing plasma components must be replenished, such as ADAMTS-13 in thrombotic thrombocytopenic purpura (TTP). The separated plasma can be further processed by pumping into a hollow fiber filter (cut-off of ~700 kD) and in this way low-density lipoprotein cholesterol and IgM can be eliminated. This treatment mode, called cascade filtration is used to treat diseases, such as Waldenström's macroglobulinemia and cryoglobulinemia. A specific way to remove antibodies is by immunoadsorption in which the antibodies are specifically removed by an adsorber. For this procedure there is no need to substitute blood products. This review article describes the principles of the two different treatment methods, the advantages and disadvantages and also summarizes the current evidence for their use in rheumatological diseases.
journal_name
Z Rheumatoljournal_title
Zeitschrift fur Rheumatologieauthors
Boser M,Kielstein JTdoi
10.1007/s00393-016-0219-7subject
Has Abstractpub_date
2016-12-01 00:00:00pages
964-972issue
10eissn
0340-1855issn
1435-1250pii
10.1007/s00393-016-0219-7journal_volume
75pub_type
杂志文章,评审abstract：:Systemic lupus erythematosus (SLE) is a classic systemic autoimmune disease. Standard treatment consists of chronic therapy with antimalarials, glucocorticoids and immunosuppressive/cytotoxic drugs, which is associated with considerable side effects. In contrast, immunoablation of autoreactive immunologic memory follo...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-008-0391-5
更新日期：2009-05-01 00:00:00
abstract：:NSAIDs, including acetylsalicylic acid, are frequently classified as peripherally-acting analgesics. This is based on the fact that these substances, among other effects, inhibit the biosynthesis of prostaglandines. A few solid arguments, however, stand against an exclusively peripheral mode of the analgesic action of...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：
更新日期：1991-01-01 00:00:00
abstract：OBJECTIVE:To assess the relative efficacy and safety of apremilast, secukinumab, and ustekinumab at different doses in patients with active psoriatic arthritis (PsA). METHOD:A Bayesian network meta-analysis was conducted, which included randomized controlled trials (RCTs) that examined the efficacy and safety of aprem...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,meta分析
doi：10.1007/s00393-017-0355-8
更新日期：2018-09-01 00:00:00
abstract：:Commonly-used serological methods for the determination of Yersinia antibodies are based on the presence of agglutinins, which are frequently absent or of low titer when arthritis begins. Stool cultures are usually negative at that time, so many Yersinia infections are underdiagnosed. On the other hand, significant ag...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1987-07-01 00:00:00
abstract：:Health policy in Germany has in recent years given priority to the self-administration of physicians, sickness funds, and hospital associations. Hence, legal regulations on quality assurance have focused on defining responsibilities and areas of primary importance, while precise processes are being defined by the self...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：10.1007/s003930050123
更新日期：1998-10-01 00:00:00
abstract：AIM:The aim of this study was to compare demographic characteristics, disease activity, functional status, and quality of life between ankylosing spondylitis (AS) with neuropatic pain (NP) and AS without NP (Non-NP). METHODS:The MEDLINE via PubMed, Cochrane, Scopus, and Embase database, from the earliest available dat...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,meta分析
doi：10.1007/s00393-019-0654-3
更新日期：2020-02-01 00:00:00
abstract：BACKGROUND:Leukotrienes and prostaglandines are important mediators of inflammation. While prostaglandine synthesis can be influenced by NSAIDs therapeutical approaches to the 5-lipoxygenase pathway are rare. Resinous extracts of Boswellia serrata (H15, indish incense), known from traditional ayurvedic medicine, decrea...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1007/s003930050051
更新日期：1998-02-01 00:00:00
abstract：:Autoinflammatory syndromes are characterized by periodic febrile attacks in combination with increased inflammatory markers. The dysregulation of different cellular signaling pathways leads to an excessive immune response, which can in turn promote multisystemic inflammatory processes. Due to overlapping symptoms, var...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-020-00847-7
更新日期：2020-09-01 00:00:00
abstract：:Based on the most recent studies, it clearly appears that long-term hormone replacement therapy (HRT) prevents fractures but does not improve established coronary artery disease. In addition, HRT leads to a small increase in breast cancer incidence and to a decrease in colorectal cancer incidence. HRT increases the in...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：10.1007/s00393-003-0559-y
更新日期：2003-12-01 00:00:00
abstract：:Among the rheumatic diseases, systemic lupus erythematosus (SLE) reveals the highest frequency of central nervous symptoms. Psychiatric abnormalities are present in over 90% of the patients, if very mild cognitive impairment is included. The psychiatric syndromes listed by the American College of Rheumatologists encom...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-004-0618-z
更新日期：2004-04-01 00:00:00
abstract：:Mainly due to the general demographic changes and decreasing mortality in rheumatic diseases based on therapeutic progress, the proportion of older patients treated by rheumatologists is growing. Drug treatment in the elderly, however, harbors certain risks including age-specific pharmacokinetic features and high rate...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-013-1245-3
更新日期：2014-04-01 00:00:00
abstract：:Fractalkine (CX3CL1), so far the only member of the CX3C class of chemokines, and its receptor, CX3CR1, are strongly expressed in the chronically inflamed synovial tissue of patients with rheumatoid arthritis (RA). Due to the specific binding of Fractalkine to its receptor, many proinflammatory reactions involved in t...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：10.1007/s00393-008-0326-1
更新日期：2008-09-01 00:00:00
abstract：:Intra-articular injection of corticosteroids is a powerful anti-inflammatory treatment with relatively few side effects. To date no prospective RCT exists on its use in children with oligoarthritis type I. Thus, in January 2000 the Arbeitsgemeinschaft started a multicenter RCT to compare in children with this diagnosi...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1007/s003930050216
更新日期：2000-04-01 00:00:00
abstract：:We tested the efficacy of the immunomodulator Bestatin, which has been successfully applied in Japan, in a preliminary open study in ten patients with classical or definite rheumatoid arthritis. Patients whose arthritis was characterized by a low humoral activity showed a partial remission of the disease after six mon...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1985-09-01 00:00:00
abstract：:Light microscopic examination of histological sections of synovial membrane from patients with rheumatoid arthritis revealed that prolonged administration of corticosteroids had an inhibiting effect on the participation of lymphocytes and histiocytes in inflammatory infiltrates, as well as on the hypertrophy of synovi...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1983-05-01 00:00:00
abstract：:The effect of D-penicillamine, given for 14 days in doses of 100 mg/kg and 225 mg/kg, upon the collagen metabolism of skin and bone tissues was studied in rats. The smaller dosage of D-penicillamine did not effect the collagen synthesis in skin or bone. When the higher dosage was used, however, an increase of collagen...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1977-05-01 00:00:00
abstract：:In the thesis of the Irish physician Bernard Connor (1666-1698) from 1693 in Rheims he describes the torso of a man whose bones were joined together due to ankylosing spondylitis which is considered to be the first example of such skeletal findings. This communication must however be seen in connection with earlier an...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 传,历史文章,杂志文章
doi：10.1007/s00393-010-0657-6
更新日期：2012-06-01 00:00:00
abstract：:Three days after cholecystectomy, seven patients received a single dose of auranofin (5 tablets Ridaura = 4.35 mg gold). At defined time points thereafter the gold content in samples of blood, plasma, urine, bile, and feces was determined by instrumental neutron activation analysis (INAA). Maxima of the mean gold conc...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1991-01-01 00:00:00
abstract：:Diffuse idiopathic skeletal hyperostosis (DISH) is characterized by, among other things, spinal and extraspinal manifestations. Two studies on the prevalence and clinical significance of hyperostotic spurs and ectopic ossifications in the pelvic area are presented. Spinal DISH seems to be a risk factor for the develop...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1988-07-01 00:00:00
abstract：:30 patients with hepatitis, 50 patients with gynecological diseases, and 100 with urological diseases were investigated with regards to lumbago to find out whether there is a correlation between the internal disease and the signs of low back pain. The patients were compared with a control group of 33 healthy people. T...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1977-05-01 00:00:00
abstract：:Due to their anti-inflammatory effects and their capacity to affect the synthesis of most cytokines and the Th1/Th2 balance, endogenous glucocorticoids contribute to control the basal operation of immune cells. Immune processes result in the production of cytokines, such as IL-1, IL-2, IL-6, IL-11, IL-12, TNF-alpha, a...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s003930070014
更新日期：2000-01-01 00:00:00
abstract：:Cartilage destruction in arthritis and osteoarthritis is linked to aberrant cytokine and growth factor expression in the affected tissues. It becomes clear that the balance of protective and destructive cytokines is more important for the net destruction than the absolute levels of destructive mediators. IL-1 is a key...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s003930050163
更新日期：1999-06-01 00:00:00
abstract：:In general, the risk of serious infections increases with age, mainly explained by immunosenescence and accumulation of comorbidities. Those patients with rheumatoid arthritis who are of advanced age and require treatment with immunosuppressive agents are at particular risk to develop an infectious disease. Actual req...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：10.1007/s00393-013-1243-5
更新日期：2014-04-01 00:00:00
abstract：:By means of the 99m-Tc-pertechnitate joint scintigraphy the authors try to document the effect of antirheumatic drugs in 62 patients with rheumatoid arthritis. By measuring the changes of the synovial blood circulation, conclusions are drawn as to the degree of inflammation. When trying to make a quantitative assessme...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 临床试验,杂志文章,随机对照试验
doi：
更新日期：1981-03-01 00:00:00
abstract：:A central problem of persons with chronic polyarthritis is the necessary adaptation to deteriorating health in everyday activities. Difficulties and burdens of this adaptation are parts of the study undertaken in the Unna Model, which was part of the research on "Local Services for CP-Patients". In the first part two ...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1992-01-01 00:00:00
abstract：:Serum protein binding of naproxen is considerably reduced in patients with renal insufficiency. The hypothetical plasma concentration at time zero and the half life are not significantly altered in uremic patients in comparison with healthy subjects when the drug is given orally. This suggests an increased pharmacodyn...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1979-03-01 00:00:00
abstract：:Temporomandibular joint affections in rheumatic disease are described. They were seen in inflamed joint diseases, mostly in rheumatoid arthritis, and less so in juvenile rheumatoid arthritis, psoriatic arthritis, Reiter's syndrome, ankylosing spondylitis, and collagen vascular disease. In osteoarthrosis, the temporoma...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：
更新日期：1988-03-01 00:00:00
abstract：:New strategies including the blockade of TNFalpha showed excellent therapeutic effects even in so far refractory rheumatic diseases. Moreover, these approaches provided us with important informations about the pathogenic role of the mediators involved and distinct autoimmune cellular subsets. Here, we discuss recent d...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-003-0539-2
更新日期：2003-08-01 00:00:00
abstract：:A 41-year-old patient with mutilating rheumatoid arthritis and progressive systemic sclerosis, who developed a chronic myeloproliferative disorder polycythemia vera was observed. Some of the pathogenetic aspects of this case with special respect to the function abnormalities of peripheral blood polymorphonuclear cells...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章
doi：
更新日期：1992-09-01 00:00:00
abstract：INTRODUCTION:Data with respect to safety and therapeutic efficacy for the combination of biological DMARDs is scarce and inhomogeneous in order to make final conclusions. To this end, data to biologic combinations is disappointing due to relatively low therapeutic efficacy and partially enhanced rates of severe infecti...
journal_title：Zeitschrift fur Rheumatologie
pub_type： 杂志文章,评审
doi：10.1007/s00393-013-1141-x
更新日期：2013-11-01 00:00:00
