Topic Highlight
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World J Gastroenterol. Aug 7, 2014; 20(29): 9699-9715
Published online Aug 7, 2014. doi: 10.3748/wjg.v20.i29.9699
Treating inflammatory bowel disease by adsorptive leucocytapheresis: A desire to treat without drugs
Abbi R Saniabadi, Tomotaka Tanaka, Toshihide Ohmori, Koji Sawada, Takayuki Yamamoto, Hiroyuki Hanai
Abbi R Saniabadi, Department of Pharmacology, Hamamatsu University School of Medicine, Hamamatsu 431-3192, Japan
Abbi R Saniabadi, JIMRO, Takasaki City, Gunma 370-0021, Japan
Tomotaka Tanaka, Department of Gastroenterology, Akitsu Prefectural Hospital, Hiroshima 739-2402, Japan
Toshihide Ohmori, Ohmori Gastrointestinal Clinic, Ageo City, Saitama 362-0075, Japan
Koji Sawada, Ikoma General and Gastroenterological Clinic, Osaka 562-0011, Japan
Takayuki Yamamoto, Inflammatory Bowel Disease Centre, Yokkaichi Social Insurance Hospital, Yokkaichi 510-0016, Japan
Hiroyuki Hanai, Hamamatsu South Hospital, Hamamatsu 430-0846, Japan
Author contributions: All the authors contributed equally to this manuscript.
Correspondence to: Abbi R Saniabadi, PhD, Department of Pharmacology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu 431-3192, Japan.
Telephone: +81-53-4352269 Fax: +81-53-4352269
Received: September 26, 2013
Revised: April 2, 2014
Accepted: April 27, 2014
Published online: August 7, 2014
Core Tip

Core tip: The efficacy of anti-tumour necrosis factor-α biologics has validated the role of inflammatory cytokines in the exacerbation of inflammatory bowel disease (IBD). However, inflammatory cytokines are released by patients’ own cellular elements including myeloid lineage leucocytes, which in patients with IBD are elevated with activation behaviour. Accordingly, these leucocytes appear logical targets of therapy and can be depleted by adsorptive granulocyte/monocyte apheresis (GMA). Therefore, in patients with IBD, there is a scope for removing from the body the sources of pro-inflammatory cytokines, and this should fulfill the desire to treat without drugs. Therefore, by introducing GMA at an early stage following the onset of IBD or before patients develop extensive mucosal damage, many patients should respond to GMA and avoid pharmacologics.