Clinical response is associated with elevated plasma interleukin-1 receptor antagonist during selective granulocyte and monocyte apheresis in patients with ulcerative colitis

Dig Dis Sci. 2006 Sep;51(9):1525-31. doi: 10.1007/s10620-005-9012-1. Epub 2006 Aug 12.


Depletion of granulocytes and monocytes (GM) by selective apheresis (GMA) with an Adacolumn exerts an anti-inflammatory effect in patients with ulcerative colitis (UC) or rheumatoid arthritis. However, the mechanism of the anti-inflammatory effect of GMA is not fully understood yet. We investigated the effect of GMA on the plasma concentration of interleukin-1 receptor antagonist (IL-1ra), a potent anti-inflammatory cytokine. Twenty-six patients with active UC received GMA at one session per week for 5 consecutive weeks. Clinical response was defined as Deltaclinical activity index (DeltaCAI=CAI at entry - CAI at post)>or=4, while clinical remission was defined as CAI<or=4. Twenty-one of twenty-six patients (80.8%) responded to GMA. In the first session, plasma from responder patients showed a significant (P < 0.01) increase in IL-1ra in the Adacolumn outflow. In contrast, there was no change in IL-1ra in nonresponders. In conclusion, release of IL-1ra during GMA might be one mechanism of clinical efficacy associated with this therapy.

Publication types

  • Clinical Trial
  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Blood Cell Count
  • Colitis, Ulcerative / blood*
  • Colitis, Ulcerative / immunology*
  • Colitis, Ulcerative / therapy
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Granulocytes / pathology
  • Granulocytes / physiology
  • Humans
  • Interleukin 1 Receptor Antagonist Protein
  • Leukapheresis / methods*
  • Male
  • Middle Aged
  • Monocytes / pathology
  • Monocytes / physiology
  • Receptors, Interleukin-1 / antagonists & inhibitors
  • Receptors, Interleukin-1 / physiology
  • Remission Induction
  • Severity of Illness Index
  • Sialoglycoproteins / blood*
  • Sialoglycoproteins / physiology
  • Treatment Outcome


  • IL1RN protein, human
  • Interleukin 1 Receptor Antagonist Protein
  • Receptors, Interleukin-1
  • Sialoglycoproteins