Skip to main content


Log in

Pilot clinical study of Adacolumn cytapheresis in patients with systemic lupus erythematosus

  • Original Article
  • Published:
Rheumatology International Aims and scope Submit manuscript


The aim of this study is to investigate the clinical effects of cytapheresis using the Adacolumn system (selective removal of circulating monocytes and granulocytes by means of an extracorporeal type column) in patients with active systemic lupus erythematosus (SLE). An open uncontrolled multicenter pilot study was conducted in 18 SLE patients who were showing a SLEDAI score of 8 or more under conventional medication. Patients with lupus nephritis (>class 1, WHO classification) were excluded. Extracorporeal cytapheresis with the Adacolumn system was administered once a week for five consecutive weeks. The efficacy of the treatment was evaluated using the SLEDAI for 10 weeks after the first cytapheresis session. The median SLEDAI decreased from 16 at baseline to six at week 11 (10 weeks after the first apheresis) (p<0.001). Significant improvements in musculoskeletal and dermal systems were observed. Arthritis and alopecia were present in 14 and nine patients at baseline and this number decreased to five and one patients, respectively by week 11.Three mild and one moderate adverse events out of the 42 reported events were judged ‘probably related’ to the treatment; no serious adverse events were reported. Selective removal of monocytes and granulocytes from the blood in an extracorporeal circulation system was associated with clinical improvement in this small series of patients with SLE. Since this approach seems not to have the disadvantages of pharmacological immunosuppression, further controlled studies of Adacolumn cytapheresis are warranted in SLE.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others


  1. Davidson A, Diamond B (2001) Autoimmune diseases. N Engl J Med 345:340–345

    Article  PubMed  CAS  Google Scholar 

  2. Sturfelt G, Bengstsson A, Klint C, Nived O, Sjöholm A, Truedsson L (2000) Novel roles of complement in systemic lupus erythematosus-hypothesis for a pathogenetic vicious circle. J Rheumatol 27:661–663

    PubMed  CAS  Google Scholar 

  3. Dar O, Salaman MR, Seifert MH, Isenberg DA (1988) B-lymphocyte activation in systemic lupus erythematosus: spontaneous production of IgG antibodies to DNA and environmental antigens in cultures of blood mononuclear cells. Clin Exp Immunol 73:430–435

    PubMed  CAS  Google Scholar 

  4. Dörner T, Lipsky PE (2004) Correlation of circulating CD27high plasma cells and disease activity in systemic lupus erythematosus. Lupus 13:283–289

    Article  PubMed  Google Scholar 

  5. Khan IU, Tsokos GC, Kammer GM (2003) Abnormal B-cell signal transduction in systemic lupus erythematosus. Curr Dir Autoimmun 6:89–104

    Article  PubMed  Google Scholar 

  6. Kumagai S, Sredni B, House S, Steinberg AD, Green I (1982) Defective regulation of B-lymphocyte colony formation in patients with systemic lupus erythematosus. J Immunol 128:258–262

    PubMed  CAS  Google Scholar 

  7. Nielsen CH, Rasmussen JM, Voss A, Junker P, Leslie RG (1998) Diminished ability of erythrocytes from patients with systemic lupus erythematosus to limit opsonized immune complex deposition on leukocytes and activation of granulocytes. Arthritis Rheum 41:613–622

    Article  PubMed  CAS  Google Scholar 

  8. Badsha H, Kong KO, Lian TY, Chan SP, Edwards CJ, Chng HH (2002) Low-dose pulse methylprednisolone for systemic lupus erythematosus flares is efficacious and has a decreased risk of infectious complications. Lupus 11:508–513

    Article  PubMed  CAS  Google Scholar 

  9. Abu-Shakra M, Urowitz MB, Gladman DD, Gough J (1995) Mortality studies in systemic lupus erythematosus. Results from a single center. I. causes of death. J Rheumatol 22:1259–1264

    PubMed  CAS  Google Scholar 

  10. Martin F, Lauwerys B, Lefebvre C, Devogelaer JP, Houssiau FA (1997) Side-effects of intravenous cyclophosphamide pulse therapy. Lupus 6:254–257

    Article  PubMed  CAS  Google Scholar 

  11. Jones JV, Robinson MF, Parciany RK, Layfer LF, McLeod B (1981) Therapeutic plasmapheresis in systemic lupus erythematosus. Effect on immune complexes and antibodies to DNA. Arthritis Rheum 24:1113–1120

    Article  PubMed  CAS  Google Scholar 

  12. Lewis EJ, Hunsicker LG, Lan SP, Rohde RD, Lachin JM (1992) A controlled trial of plasmapheresis therapy in severe lupus nephritis. The lupus nephritis collaborative study group. N Engl J Med 326:1373–1379

    Article  PubMed  CAS  Google Scholar 

  13. Looney RJ, Anolik JH, Campbell D, Felgar RE, Young F, Arend LJ, Sloand JA, Rosenblatt J, Sanz I (2004) B-cell depletion as a novel treatment for systemic lupus erythematosus. Arthritis Rheum 50:2580–2589

    Article  PubMed  CAS  Google Scholar 

  14. Boumpas DT, Furie R, Manzi S, Illei GG, Wallace DJ, Balow JE, Vaishnaw A (2003) BG9588 Lupus nephritis trial group. A short course of BG9588 (anti-CD40 ligand antibody) improves serologic activity and decreases hematuria in patients with proliferative lupus glomerulonephritis. Arthritis Rheum 48:719–727

    Article  PubMed  CAS  Google Scholar 

  15. Hiraish K, Takeda Y, Shiobara N, Shibusawa H, Jimma F, Kahiwagi N, Saniabadi AR, Adachi M (2003) Studies on the mechanisms of leukocyte adhesion to cellulose acetate beads: an in vitro model to assess the efficacy of cellulose acetate carrier-based granulocyte and monocyte adsorptive apheresis. Ther Apher Dial 7(3):334–340

    Article  Google Scholar 

  16. Kashiwagi N, Hirata I, Kasukawa R (1998) A role for granulocyte and monocyte apheresis in the treatment of rheumatoid arthritis. Ther Apher 2:134–141

    Article  PubMed  CAS  Google Scholar 

  17. Kashiwagi N, Sugimura K, Koiwai H, Yamamoto H, Yoshikawa T, Saniabadi AR, Adachi M, Shimoyama T (2002) Immunomodulatory effects of granulocyte and monocyte adsorption apheresis as a treatment for patients with ulcerative colitis. Dig Dis Sci 47:1334–1341

    Article  PubMed  CAS  Google Scholar 

  18. Shimoyama T, Sawada K, Hiwatashi N, Sawada T, Matsueda K, Munakata A, Asakura H, Tanaka T, Kasukawa R, Kimura K, Suzuki Y, Nagamachi Y, Muto T, Nagawa H, Iizuka B, Baba S, Nasu M, Kataoka T, Kashiwagi N, Saniabadi AR (2001) Safety and efficacy of granulocyte and monocyte adsorption apheresis in patients with active ulcerative colitis: a multicenter study. J Clin Apher 16:1–9

    Article  PubMed  CAS  Google Scholar 

  19. Kanekura T, Maruyama I, Kanzaki (2002) Granulocyte and monocyte adsorption apheresis for pyoderma gangrenosum. J Am Acad Dermatol 47:320–321

    Article  PubMed  Google Scholar 

  20. Saniabadi AR, Hanai H, Takeuchi K, Umemura K, Nakashima M, Adachi T, Shima C, Bjarnason I, Lofberg R (2003) Adocolumn, an adsorptive carrier based granulocyte and monocyte apheresis device for the treatment of inflammatory and refractory diseases associated with leukocytes. Ther Apher Dial 7:48–59

    Article  PubMed  Google Scholar 

  21. Hochberg MC (1997) Updating the American College of Rheumatology revised criteria for the classification of systemic lupus erythematosus. Arthritis Rheum 40:1725

    Article  PubMed  CAS  Google Scholar 

  22. Bombardier C, Gladman DD, Urowitz MB, Caron D, Chang CH (1992) Deviation of the SLEDAI: a disease activity index for lupus patients. Arthritis Rheum 35:630–638

    Article  PubMed  CAS  Google Scholar 

  23. Uesugi H, Ozaki S, Sobajima J, Osakada F, Shirakawa H, Yoshida M, Nakao K (1998) Prevalence and characterization of novel pANCA, antibodies to the high mobility group non-histone chromosomal proteins HMG1 and HMG2, in systemic rheumatic diseases. J Rheumatol 25:703–709

    PubMed  CAS  Google Scholar 

  24. Hashimoto Y, Nakano K, Yoshinoya S, Tanimoto K, Itoh K (1992) Endothelial cell destruction by polymorphonuclear leukocytes incubated with sera from patients with systemic lupus erythematosus. Scan J Rheumatol 21:209–214

    Article  CAS  Google Scholar 

  25. Kashiwagi N, Nakano M, Saniabadi AR, Adachi M, Yoshikawa T (2002) Anti-inflammatory effect of granulocyte and monocyte adsorption apheresis in a rabbit model of immune arthritis. Inflammation 26:199–205

    Article  PubMed  Google Scholar 

  26. Kanekura T, Hashiguchi T, Mera Y, Katahira A, Nakamura I, Maruyama I, Kanzaki T (2004) Improvement of SLE skin rash with granulocyte and monocyte adsorption apheresis. Dermatology 208:79–80

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations


Corresponding author

Correspondence to Marita Franz.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Soerensen, H., Schneidewind-Mueller, JM., Lange, D. et al. Pilot clinical study of Adacolumn cytapheresis in patients with systemic lupus erythematosus. Rheumatol Int 26, 409–415 (2006).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: