Therapeutic Selective Adsorption of Anti‐DNA Antibody Using Dextran Sulfate Cellulose Column (Selesorb) for the Treatment of Systemic Lupus Erythematosus

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Abstract
The Selesorb therapeutic dextran sulfate cellulose column (Kaneka Corporation, Osaka, Japan) selectively adsorbs anti‐DNA antibody, anti‐cardiolipin antibody, and immune complex from the plasma of patients with systemic lupus erythematosus (SLE). The Selesorb system is composed of twin columns attached to an automated regeneration apheresis unit. Anti‐DNA antibody in plasma is continuously removed through 1 of the 2 columns alternately. Clinical application of the Selesorb system to SLE patients with high titers of anti‐DNA antibody showed improvement of proteinurea, arthralgia, rash, lymphocytopenia, etc., with the concurrent use of steroid and/ or immnosuppressant. Angiotensin converting enzyme inhibitor should not be administered to patients treated with the Selesorb system to avoid anaphylactoid reactions based on rapid increases of bradykinin concentrations in the blood.Abstract: The Selesorb system removed anti‐DNA antibody, anticardiolipin antibody and immune complex from the plasma of SLE patients. Other biochemical parameters such as total protein and albumin remained at almost the same levels as before apheresis. The efficiency of the removal of anti‐DNA antibody was maintained during the treatment using the 2 adsorbent columns with alternate use of adsorption and regeneration using the automated apheresis unit MA‐01. Clinical manifestations such as proteinurea, arthralgia, rash, lymphocytopenia, etc., were improved under concomitant use of conventional immunosuppressants during Selesorb treatments. Care should be taken not to administer ACE inhibitor to patients treated with the Selesorb column to avoid anaphylactoid reactions.