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ORIGINAL RESEARCH

Leukocytapheresis Therapy for Rheumatoid

Arthritis: Results Compared with Control Trial

Jia Huang, MD; Qian Wang, MD; Yongjing Cheng, PhD; Yingjuan Chen, PhD; Ming Gao, MD;
Feng Yang, MD; Bingyao Mu, MD; Rongwei Zhou, MD; Cibo Huang, MD

ABSTRACT
Context • Rheumatoid arthritis (RA) is a chronic (4) C-reactive protein levels (CRP), (5) a visual analog
multisystem autoimmune disease, mainly characterized scale (VAS) for pain, (6) the DAS28 C-reactive protein
by synovitis and with symmetrical joint involvement. (DAS28-CRP) scores, and the Health Assessment
LCAP therapy for RA patients has been shown to be safe Questionnaire Disability Index (HAQ-DI). The study also
and efficacious in some developed countries for over a evaluated participants’ scores for the American College of
decade. Rheumatology (ACR) Core Data Set. Serum collected
Objective • The study intended to evaluate the efficacy before and after therapy from both groups was analyzed for
and safety of leukocytopheresis (LCAP) for treatment of the levels of bradykinin, serotonin, heat shock protein 70,
rheumatoid arthritis (RA) and to study the influence of human CXC-chemokine ligand 16 (CXCL16), prostaglandin
treatment on the levels of various serum cytokines. E2, and macrophage inflammation protein 1α.
Design • The study was a nonblinded, nonrandomized, Results • At week 4 for participants receiving the LCAP
controlled trial. therapy, ACR20, ACR50, and ACR70 were observed in
Setting • The study took place in the Department of 55%, 30%, and 20% of patients, respectively, compared to
Rheumatology and Immunology at Beijing Hospital at the 19.4%, 3.2%, and 0% for patients in the control group
National Center of Gerontology in Beijing, China. (P < .05). Also, at week 24 of LCAP therapy, ACR20,
Participants • Participants were 51 patients with RA at ACR50, and ACR70 were observed in 70%, 50%, and 30%
the hospital with a 28-joint disease activity score (DAS28) of patients, respectively, which was significantly higher
exceeding the 3.20 needed to fulfill the classification than the 25.8%, 12.9%, and 3.2% of patients in the control
criteria of the American College of Rheumatology (ACR). group (P < .05). The serum levels of CXCL16 and serotonin
Intervention • Participants were divided into 2 groups. were significantly reduced in the LCAP group compared
One group (intervention group) received LCAP therapy with control group.
(n = 20), while the control group (n = 31) received disease- Conclusions • This study indicated that LCAP therapy
modifying antirheumatic drugs (DMARDs). Patients can significantly decrease RA disease activity and is a safe
receiving the LCAP therapy were treated using a Cellsorba and effective alternative therapy. LCAP therapy
column every 5 days for a total of 5 treatments. significantly reduced serum CXCL16 and serotonin levels,
Outcome Measures • Clinical assessment of participants’ offering a putative mechanism by which it improves the
symptoms included: (1) a tender-joint count, (2) a swollen- articular symptoms of RA. (Altern Ther Health Med.
joint count, (3) erythrocyte sedimentation rates (ESR), 2020;26(4):36-42).

Jia Huang, MD; Qian Wang, MD; Yongjing Cheng, PhD; INTRODUCTION
Yingjuan Chen, PhD; Ming Gao, MD; Feng Yang, MD; Rheumatoid arthritis (RA) is a chronic multisystem
Bingyao Mu, MD; Rongwei Zhou, MD; Cibo Huang, MD; are autoimmune disease, mainly characterized by synovitis and
all in the Department of Rheumatology and Immunology, with symmetrical joint involvement. Interleukin (IL)-1,
Beijing Hospital, National Center of Gerontology, Beijing, tumor necrosis factor (TNF), and other cytokines cause the
China. synovitis, which in turn leads to cartilage damage, bone
erosion, and joint-structure damage. Various auto-antibodies
that are inflammatory factors or mediators responsible for
Corresponding author: Cibo Huang, MD RA pathogenesis are present in the blood circulation of
E-mail address: huangcb_2017@163.com people with RA. 1

36 ALTERNATIVE THERAPIES, JUL/AUG 2020 VOL. 26 NO. 4 Huang—Leukocytapheresis Therapy for Rheumatoid Arthritis