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Abstract #28182 Published in IGR 13-1
Glaucoma a new indication for immunoadsorption
Rech J; Wallukat G; Schett G; Herrmann M; Kunze R; Juenemann ATransfusion and Apheresis Science 2010; 43: S20
Introduction: Glaucoma is a frequent ocular disease leading to blindness. Primary open-angle glaucoma (POAG) and ocular hypertension (OHT) are common forms of glaucomatous diseases. The disorders are driven by high intraocular pressure. Their pathogenesis is widely unknown. We screened the sera of patients with POAG and OHT for the prevalence of autoantibodies (AABs) against G protein coupled receptors (GPCRs). Stimulatory AABs against b2 adrenergic receptors (b2ARs) were detected in roughly 75% of the patients with POAG and OHT by a bioassay using spontaneously beating neonatal rat cardiomyocytes. Material and Methods: Extracorporal plasma separation was performed in 5 patients by centrifugation technique (Cobe Spectra(registered trademark)) while the running parameters such as column volume, loading volume, desorption and regeneration volume, speed of processing and numbers of cycles were fixed and controlled by the Adasorb(registered trademark) device (medicap, Ulrichstein). One treatment cycle consist of treatment on five consecutive days of immunoadsorption by using two reusable adsorbers (Globaffin(registered trademark), Fresenius Medical Care Affina GmbH). Results: In this report, we describe formerly unknown glaucoma AABs and the therapeutic possibility by using immunoadsorption technique. 5 patients out of this collective were treated by selective immunoadsorption.We could show that all patients respond to this treatment and two out of 5 were still in complete remission without any treatment now for two years. Discussion: Glaucoma is one of the leading causes of blindness in the world. It is suggested that over 67 million people are affected by glaucoma. Current glaucoma therapy is directed at lowering IOP by using the (beta)2AR blocker Timolol. With the detection of agonistic antibodies in 75% of our glaucoma patients, new therapeutic possibilities like immunoadsorption become an alternative. With respect, these findings should be interpreted with caution, but they support the need for future trials to further assess the therapeutic potential of immunoadsorption in glaucoma patients.
J. Rech.
