Medical information for doctors
The principle of immunoadsorption
by Priv.-Doz. Dr. med. Markus Meier
Immunoadsorption is a new method used in nephrology for selective removal of antibodies from the blood. As with a blood donation, the procedure involves inserting a needle into the crook of the patient's left arm and right arm (i.e., the inside of the arm where the arm bends). A central venous line is very rarely needed.
The first step in apheresis for atopic eczema is to separate the plasma from the rest of the blood (plasma separation, see picture). In the second step, the IgE from the separated plasma is bound specifically to a column (adsorption) using an antibody and in that way removed from the extracorporeal circuit. All other blood and plasma components are left unchanged and are infused back to the patient.
As each column is "regenerated" by rinsing with buffer solutions after full loading with the IgE antibody, continuous treatment (picture) is provided by having two columns that are alternately filled with plasma and emptied. This allows immunoglobulin E levels to be reduced by more than 80%-90% during a single treatment session lasting 3 to 4 hours.
A major advantage of immunoadsorption versus other apheresis methods is the specific elimination of pathogenic substances. As a result, the treatment has very few and very minor side effects. The only side effect observed in the more than 200 treatments carried out so far has been minor postural hypotension.