Cytapheresis in Inflammatory Bowel Diseases: Current Evidence and Perspectives

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Vol. 77, No. 2, 2008

Review

Cytapheresis in Inflammatory Bowel Diseases: Current Evidence and PerspectivesSilvio Danesea, Angeluccib, Tommaso Stefanellia, Paolo Omodeia, Carmelo Luigianoa, Silvia Finazzia, Nico Paganoa, Alessandro Repicia, Maurizio Vecchic, Alberto MalesciaaDivision of Gastroenterology, Istituto Clinico Humanitas, IRCCS in Gastroenterology, University of Milan, Rozzano/Milan,bDivision of Gastroenterology, Policlinico Umberto I, Università Sapienza, Rome, andcDivision of Gastroenterology, IRCCS-Policlinico San Donato Milanese, University of Milan, Milan, Italy

Address of Corresponding Author

Digestion 2008;77:96-107 (DOI: 10.1159/000122473)

Abstract

Ulcerative colitis and Crohn's disease are inflammatory bowel diseases with a chronic relapsing course. Management of both conditions is far from being fully satisfactory. For this reason in the last decade a large number of biological therapies, targeting cytokines involved in intestinal inflammation, has been developed with various results in terms of efficacy, safety and costs. Activated granulocytes and monocytes represent the major sources of pro-inflammatory cytokines in the intestinal mucosa, playing a pivotal role in inducing and maintaining intestinal inflammation. Leukocytapheresis using an adsorptive carrier-based system (Adacolumn®) or a removal filter column (Cellsorba®) has been proposed as a feasible, safe and effective therapy for ulcerative colitis and Crohn's disease. The objective of this paper is to provide an overview on the current knowledge about mechanisms of action, available clinical data and the possible future perspectives for the use of Adacolumn and Cellsorba in the management of inflammatory bowel diseases.

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