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Title: Effect of intensive granulocyte and monocyte adsorptive apheresis in patients with ulcerative colitis positive for cytomegalovirus.
Authors: Fukuchi, Takumi
Nakase, Hiroshi  KAKEN_id
Matsuura, Minoru  kyouindb  KAKEN_id
Yoshino, Takuya  KAKEN_id
Toyonaga, Takahiko
Ohmori, Katsuyuki
Ubukata, Satoshi
Ueda, Aya
Eguchi, Takaaki
Yamashita, Hiroshi
Ito, Dai
Ashida, Kiyoshi
Author's alias: 仲瀬, 裕志
Keywords: Ulcerative colitis
Granulocyte and monocyte adsorptive apheresis
Cytomegalovirus
Issue Date: 1-Nov-2013
Publisher: Elsevier B.V.
Journal title: Journal of Crohn's & colitis
Volume: 7
Issue: 10
Start page: 803
End page: 811
Abstract: [Background and aim]Cytomegalovirus (CMV) exacerbates ulcerative colitis (UC) refractory to immunosuppressive therapies. The conditions under which CMV reactivation occurs in patients with UC, however, is unclear. In addition, the diagnostic and treatment strategies for UC positive for CMV have not been established. Granulocyte and monocyte adsorptive apheresis (GMAA) is natural biological therapy for UC in which the granulocytes/macrophages producing inflammatory cytokines are removed. We investigated the rate of colonic CMV reactivation and the efficacy of GMAA in active UC patients positive for CMV without concomitant corticosteroid (CS) therapy. [Methods]Fifty-one active UC patients without concomitant CS therapy were enrolled. Colonic CMV reactivation was examined by real-time polymerase chain reaction (PCR) using biopsy specimen and/or histological examination. All patients were treated with intensive GMAA (twice per week). Rates of clinical remission and mucosal healing were compared between UC patients positive and negative for CMV. [Results]Of 51 patients, 15 (29.4%) were diagnosed as CMV positive. The clinical remission rates following intensive GMAA did not differ between UC patients positive and negative for CMV (73.3% vs 69.4%, p = 0.781). Proportion of patients achieving mucosal healing was also similar between these two groups. CMV-DNA became negative in all UC patients positive for CMV who achieved clinical remission 1 week after completion of intensive GMAA. [Conclusions]Intestinal inflammation might trigger CMV reactivation in a subpopulation of active UC patients without CS treatment. GMAA could be a promising option for active UC positive for CMV.
Rights: © 2012 European Crohn's and Colitis Organisation. Published by Elsevier B.V.
この論文は出版社版でありません。引用の際には出版社版をご確認ご利用ください。
This is not the published version. Please cite only the published version.
URI: http://hdl.handle.net/2433/179280
DOI(Published Version): 10.1016/j.crohns.2012.12.003
PubMed ID: 23352104
Appears in Collections:Journal Articles

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