Immunoadsorption and plasma exchange—Efficient treatment options for neurological autoimmune diseases

Currently, there is still no cure for multiple sclerosis (MS), which is an autoimmune and neurodegenerative disease of the central nervous system. Treatment options predominantly consist of drugs that affect adaptive immunity and lead to a reduction of the inflammatory disease activity. A broad range of possible cell-based therapeutic options are being explored in the treatment of autoimmune diseases, including MS. This review aims to provide an overview of recent and future advances in the development of cell-based treatment options for the induction of tolerance in MS. Here, we will focus on haematopoietic stem cells, mesenchymal stromal cells, regulatory T cells and dendritic cells. We will also focus on less familiar cell types that are used in cell therapy, including B cells, natural killer cells and peripheral blood mononuclear cells. We will address key issues regarding the depicted therapies and highlight the major challenges that lie ahead to successfully reverse autoimmune diseases, such as MS, while minimising the side effects. Although cell-based therapies are well known and used in the treatment of several cancers, cell-based treatment options hold promise for the future treatment of autoimmune diseases in general, and MS in particular.

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Updates on the understanding and management of thyroid eye disease

Therapeutic Advances in Ophthalmology ◽

10.1177/25158414211027760 ◽

2021 ◽

Vol 13 ◽

pp. 251584142110277

Author(s):

Clara J. Men ◽

Andrea L. Kossler ◽

Sara T. Wester

Keyword(s):

Autoimmune Diseases ◽

Immune Modulation ◽

Complex Disease ◽

Vision Loss ◽

Treatment Options ◽

Thyroid Stimulating Hormone ◽

Thyroid Eye Disease ◽

Eye Disease ◽

Signaling Complex ◽

Clinical Trial Results

Thyroid eye disease (TED) is a complex disease associated with myriad clinical presentations, including facial disfigurement, vision loss, and decreased quality of life. Traditionally, steroid therapy and/or radiation therapy were commonly used in the treatment of active TED. While these therapies can help reduce inflammation, they often do not have a sustainable, significant long-term effect on disease outcomes, including proptosis and diplopia. Recent advances in our understanding of the pathophysiology of TED have shifted the focus of treatment toward targeted biologic therapies. Biologics have the advantage of precise immune modulation, which can have better safety profiles and greater efficacy compared to traditional approaches. For instance, the insulin-like growth factor-1 receptor (IGF-1R) has been found to be upregulated in TED patients and to colocalize with the thyroid-stimulating hormone receptor (TSHR), forming a signaling complex. Teprotumumab is an antibody targeted against IGF-1R. By inhibiting the IGF-1R/TSHR signaling pathway, teprotumumab may reduce the production of proinflammatory cytokines, hyaluronan secretion, and orbital fibroblast activation in patients with TED. Due to promising phase II and III clinical trial results, teprotumumab has become the first biologic US Food and Drug Administration (FDA)-approved for the treatment of TED. In addition, there are currently ongoing studies looking at the use of antibodies targeting the neonatal Fc receptor (FcRn) in various autoimmune diseases, including TED. FcRn functions to transport immunoglobulin G (IgG) and prevent their lysosomal degradation. By blocking the recycling of IgG, this approach may dampen the body’s immune response, in particular the pathogenic IgG implicated in some autoimmune diseases. Advances in our understanding of the pathophysiology of TED, therefore, are leading to more targeted therapeutic options, and we are entering an exciting new phase in the management of TED. This review will cover recent insights into the understanding of TED pathophysiology and novel treatment options as well as ongoing studies of new potential treatment options for TED.

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Pharmacologic treatment of osteoporosis – 2011

Orvosi Hetilap ◽

10.1556/oh.2011.29111 ◽

2011 ◽

Vol 152 (33) ◽

pp. 1320-1326 ◽

Cited By ~ 2

Author(s):

Péter Lakatos

Keyword(s):

Bone Loss ◽

Fracture Risk ◽

Hormone Replacement ◽

Treatment Options ◽

Osteoporotic Fractures ◽

Cost Effective ◽

Similar Efficacy ◽

High Fracture ◽

Efficient Treatment ◽

Treatment Of Osteoporosis

Osteoporosis affects approximately 9% of the population in Hungary resulting in about 100 000 osteoporotic fractures annually. Thirty-five percent of patients with hip fractures due to osteoporosis will die within 1 year. Direct costs of osteoporosis exceed 25 billion forints per year. Apparently, cost-effective reduction of bone loss and consequent fracture risk will add up to not only financial savings but improvement in quality of life, as well. A number of pharmacological modalities are available for this purpose. The mainstay of the treatment of osteoporosis is the bisphosphonate group that includes effective anti-resorptive compounds mitigating bone loss and fragility. The recently registered denosumab exhibits similar efficacy by neutralizing RANK ligand, however, marked differences can be observed between the two drug classes. Strontium has a unique mechanism of action by rebalancing bone turnover, and thus, providing an efficient treatment option for the not fast bone losers who are at high fracture risk. The purely anabolic teriparatide is available for the extremely severe osteoporotic patients and for those who do not respond to other types of therapy. Older treatment options such as hormone replacement therapy, raloxifene, tibolone or calcitonin may also have a restricted place in the management of osteoporosis. Orv. Hetil., 2011, 152, 1320–1326.

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Neurological Autoimmune Diseases

Encyclopedia of Immunology ◽

10.1006/rwei.1999.0461 ◽

1998 ◽

pp. 1834-1843

Author(s):

Barry G.W. Arnason

Keyword(s):

Autoimmune Diseases ◽

Neurological Autoimmune Diseases

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Plasmapheresis for the Treatment of Acute Pancreatitis due to Severe Hypertriglyceridemia

Blood Purification ◽

10.1159/000510647 ◽

2020 ◽

pp. 1-3

Author(s):

Juan Carlos Ruiz-Rodríguez ◽

Luis Silvestre Chiscano-Camón ◽

Clara Palmada ◽

Verónica Pons ◽

Ricard Ferrer

Keyword(s):

Acute Pancreatitis ◽

Plasma Exchange ◽

Treatment Options ◽

Total Plasma ◽

Severe Hypertriglyceridemia ◽

Total Plasma Exchange

Severe hypertriglyceridemia (HTG) is associated with acute pancreatitis (AP). Treatment options include total plasma exchange (TPE). We report a case of AP due to severe HTG treated with TPE.

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Editorial: Current Strategies for Drug Discovery Targeting Neurological Autoimmune Diseases

Central Nervous System Agents in Medicinal Chemistry ◽

10.2174/187152491801180126155303 ◽

2018 ◽

Vol 18 (1) ◽

Author(s):

Dusanka S. Skundric

Keyword(s):

Drug Discovery ◽

Autoimmune Diseases ◽

Neurological Autoimmune Diseases

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Total Plasma Exchange in Hypertriglyceridemia-Induced Pancreatitis: Case Report and Literature Review

Case Reports in Medicine ◽

10.1155/2018/4017573 ◽

2018 ◽

Vol 2018 ◽

pp. 1-3 ◽

Cited By ~ 2

Author(s):

Harleen Dehal ◽

Michael Adashek

Keyword(s):

Plasma Exchange ◽

Treatment Options ◽

Clinical Status ◽

Clinical Situation ◽

Dramatic Improvement ◽

Total Plasma ◽

Rapid Fall ◽

The Many ◽

Total Plasma Exchange

Objective. To emphasize the role of apheresis in management of pancreatitis. Methods. The clinical course of a patient admitted for hypertriglyceridemia-induced pancreatitis (HTGP) complicated by multiorgan dysfunction is described, who demonstrated dramatic improvement in his clinical status after total plasma exchange (TPE). In addition, the current guidelines for TPE and the alternative treatment options for HTGP are also presented. Results. A patient presenting with pancreatitis associated with severe systemic inflammatory response was admitted to our hospital with an initial triglyceride level of 1181 mg/dL. Given the patient’s worsening clinical condition, he was started on TPE with a rapid fall in his serum TG levels, in turn leading to early clinical recovery. Conclusion. Though various therapeutic options for the treatment of HTGP are described in literature, there are no set guidelines available to tackle this difficult clinical situation. TPE, albeit not very well known in this context, is one of the many therapies available. Though it leads to a rapid, precipitous fall in the TG levels and early symptom resolution, the data about the long-term morbidity as well as the effectiveness of this therapy is still lacking.

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NATURAL PRODUCTS IN TREATMENT OF ENCEPHALITIS: A REVIEW

PLANT ARCHIVES ◽

10.51470/plantarchives.2021.v21.no1.050 ◽

2021 ◽

Vol 21 (no 1) ◽

Author(s):

Danishpreet Kaur Takhar ◽

Mukta Gupta

Keyword(s):

Natural Products ◽

Nmda Receptor ◽

Plasma Exchange ◽

Intravenous Immunoglobulin ◽

Psychotic Disorders ◽

Treatment Options ◽

Therapeutic Approaches ◽

Nmda Receptor Encephalitis ◽

Aspartate Receptor

Brain on fire, an unusual phrase used for the deadliest autoimmune ailment, called anti-NMDA (N-methyl-D-aspartate) receptor encephalitis, characterizing extreme psychiatric and neurotic signs. Though being the deadliest one, still it can be treated with the help of various therapeutic approaches such as Corticosteroids, Intravenous immunoglobulin (IVIG) and plasmapheresis or plasma exchange. Although the prevalence of encephalitis can be observed in both the sexes, however the majority of ailment (95%) is seen in women with teratoma ovaries or different neoplasms. Recognition of nti-NMDA receptor encephalitis could be very essential to avoid any misconception regarding incorrect interpretation of various psychotic disorders. However, various treatment options are available still further investigation should be required to carried out to find out other clinically beneficial drugs.

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Therapeutic Plasma Exchange in Guillain Barre Syndrome: An experience of Bangabanhu Sheikh Mujib Medical University, Bangladesh

European Journal of Medical and Health Sciences ◽

10.24018/ejmed.2022.4.1.937 ◽

2022 ◽

Vol 4 (1) ◽

pp. 11-13

Author(s):

Sheikh Saiful Islam ◽

Jannatul Ferdous ◽

Ashraful Hoque ◽

Atiar Rahman

Keyword(s):

Plasma Exchange ◽

Treatment Modality ◽

Neurological Diseases ◽

Treatment Options ◽

Therapeutic Plasma Exchange ◽

Guillain Barre Syndrome ◽

Treatment Modalities ◽

Guillain Barré Syndrome ◽

Guillain Barré ◽

Medical University

Background: Therapeutic plasma exchange (TPE) has been used as one of the treatment modalities of neurological diseases. Intravenous Immunoglobulin (IVIG) and Therapeutic Plasma Exchange (TPE)are treatment options in Guillain Barre syndrome (GBS). In developing countries IVIG is not easily available and it is also expensive, TPE is preferred for treatment of GBS as it is affordable. Study on TPE for GBS are scarce here. Most of the study regarding TPE in GBS has been conducted in high –income countries as it is expensive treatment modality. Reports on TPE in GBS is very scared from Bangladesh. Materials and Methods: A retrospective analysis of TPE with a standard hemolysis equipment for the treatment of Guillain Barre syndrome (GBS) was conducted A 50 patients of GBS who received TPE conducted between January 2017 to December 2018 in the department of Transfusion Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh were analyzed. All patients had underdone at least 2 cycles of plasma exchange. Volume exchanged in each cycle was one plasma volume. Results: Out of 50 cases there were 43 (86%) male and 7 (14%) female. Age range of patients was from 11 – 50 years. Approximately 40% improved clinically of first cycle of PE & 85% after second cycle, 95% after third cycle and 95-100% after 5 cycle. 1(2%) patient died, and 49(98%) patients survived and recovered. Conclusion: The treatment is cost affection in Compassion to IVIG. TPE is and affection, safe and affordable treatment modality for GBS.

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Retomando los caminos de vida: Psicoterapia ericksoniana en combinación con el drama ritual de la terapia sistémica de Bert Hellinger (Constelaciones Familiares) para pacientes con duelo complicado

10.31234/osf.io/a6trm ◽

2019 ◽

Author(s):

Oleg Gorfinkel

Keyword(s):

Systemic Therapy ◽

Treatment Options ◽

Complicated Grief ◽

Patient Treatment ◽

Treatment Model ◽

Single Session ◽

Efficient Treatment ◽

The Public ◽

Group Format ◽

Salud Mental

El duelo complicado apenas está siendo reconocido en el campo de salud mental como un trastorno con un perfil y una etiología muy propios, que por lo tanto requiere de estrategias e intervenciones psicoterapéuticas especialmente adaptadas a sus factores particulares. La experiencia clínica en la psicoterapia ericksoniana, así como en la terapia sistémica de Bert Hellinger (Constelaciones Familiares), advierte la posibilidad de desarrollar, a partir de una integración de estos dos enfoques, un tratamiento eficiente que pueda ser impartido en forma grupal y en una sola sesión. Las ventajas de tal modelo de intervención son evidentes, ya que permitirá reducir de manera muy significativa tanto el tiempo como el costo del tratamiento por paciente, así ampliando su accesibilidad y disponibilidad para el público que lo necesite. Por lo tanto, la presente investigación se abocó a (1) desarrollar un modelo de tratamiento para duelo complicado, basado en una integración de la psicoterapia ericksoniana y de la terapia sistémica de Bert Hellinger (Constelaciones Familiares), para ser aplicado en forma grupal y en una sola sesión, y (2) aplicar dicho tratamiento en pacientes diagnosticados con duelo complicado y evaluar su eficacia para disminuir los síntomas del trastorno. Se espera que al alcanzar dichos objetivos, este trabajo sirva para mejorar las opciones de tratamiento disponibles para las personas que sufren del duelo complicado. ENGLISH: Complicated grief is only now gaining recognition in the mental health field as a disorder with its own distinct profile and etiology, and one that requires psychotherapeutic strategies and interventions specially adapted to its peculiar features. Clinical experience in both Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations), suggests that through an integration of these two methods, it is possible to develop an efficient treatment to be administered in a group format and in a single session. The advantages of such a treatment model are evident, as it provides a significant reduction in both the time and the per-patient treatment cost, thus making treatment more available and accessible for the public that needs it. For this reason, the present research has aimed at (1) developing a treatment model for complicated grief, based on an integration of Ericksonian psychotherapy and Bert Hellinger's systemic therapy (Family Constellations) and suitable for being administered in a group format and in a single session; (2) applying said treatment in patients diagnosed with complicated grief and evaluating its effectiveness in reducing the symptoms of the disorder. It is hoped that through meeting the above goals, this research will serve to improve the treatment options available to individuals suffering from complicated grief.

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