Myasthenia gravis therapy: immunoadsorbent may eliminate need for plasma products
Ben H. Brouhard, MD
Koji Sawada, MD
Paul S. Malchesky, DEngAddress reprint requests to P.S.M., Department of Biomedical Engineering and Applied Therapeutics, Wb3, The Cleveland Clinic Foundation, 9500 Euclid Avenue, Cleveland, OH 44195.
Anna P. Koo, MD
Hiroshi Mitsumoto, MD
This in vitro study assessed the effectiveness of a new immunoadsorbent (Asahi IM-TR 350) in removing anti-acetylcholine receptor antibody from plasma with minimal loss of albumin. Plasma procured from a myasthenia gravis patient undergoing routine plasma exchange was perfused through the immunoadsorbent and recirculated in vitro to simulate a clinical treatment. To assess the temperature dependency of sorption, perfusion was performed at various temperatures. Plasma solute concentrations were taken before and after perfusion to calculate solute rejection coefficients. The immunoadsorbent has a high sorption capacity for anti-acetylcholine receptor antibody, while allowing a minimum loss of albumin. For patients with myasthenia gravis, this immunoadsorbent can provide an alternative to plasma exchange that does not require the use of plasma products.