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Blood filter to remove cytokines

Messages
5
I just read an article about a new device that can be used to treat sepsis by filtering out specific cytokines that are being over-produced. I know that the FM/a test uses cytokines to identify fibromyalgia (also aware of the controversy surrounding this method). I'm wondering if filtering out specific cytokines could make CFS/ME patients feel better. Obviously is an extreme measure, and not a good long term solution, but if it were tried on CFS/ME patients, and caused an improvement, it would be a great clue on what's going on.

https://news.mit.edu/2016/sepsis-curing-device-wins-mit-sloan-healthcare-innovations-prize-0226
 

Gingergrrl

Senior Member
Messages
16,171
I had the same question, isn't a blood filter to remove cytokines or antibodies the same as plasmapheresis? Has anyone on PR ever attempted this?
 

Jonathan Edwards

"Gibberish"
Messages
5,256
I had the same question, isn't a blood filter to remove cytokines or antibodies the same as plasmapheresis? Has anyone on PR ever attempted this?

I think this is a filter painted with anti-cytokine antibodies that would remove specific cytokines and nothing else. That makes some sense as a research tool but I would expect the effect on symptoms to last about half an hour after you stopped the filtering, so not much good for treatment.
 

Gingergrrl

Senior Member
Messages
16,171
I think this is a filter painted with anti-cytokine antibodies that would remove specific cytokines and nothing else. That makes some sense as a research tool but I would expect the effect on symptoms to last about half an hour after you stopped the filtering, so not much good for treatment.

Would this machine or regular plasmapheresis remove antibodies or only cytokines? Sorry if this is a stupid question.
 
Messages
36
If anything, I see this as a temporary relief more than anything else - since even after the excess cytokines have been filtered, it will only be a matter of time before they are reproduced. Then again, this applies to all medication..

Do they have a % rate yet?
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Would this machine or regular plasmapheresis remove antibodies or only cytokines? Sorry if this is a stupid question.

Regular plasmapheresis removes antibodies and works in quite a wide range of autoimmune diseases. It used to be risky because of fluid shifts and clotting problems but is much slicker now. It is a good way to get rid of antibodies straight away. Rituximab is much slower but lasts much longer. You cannot really do both at once because plasmapheresis will take out the rituximab, but you can do them in sequence and that may be a good plan, although I don;t think it has been tried very often. Plamapheresis is the choice of Dr Angela Vincent who knows a lot about the rare autoimmune diseases with antibodies to nervous system antigens - where you want quick improvement.
 

Gingergrrl

Senior Member
Messages
16,171
Regular plasmapheresis removes antibodies and works in quite a wide range of autoimmune diseases.

Thank you and I was curious, is it a one time treatment or something that people have to do weekly like dialysis?

It used to be risky because of fluid shifts and clotting problems but is much slicker now. It is a good way to get rid of antibodies straight away.

Fluid shifts and clotting are two potential issues for me which make me think plasmapheresis would be too risky. No doc has recommended it for me, but something I was curious about.

Rituximab is much slower but lasts much longer. You cannot really do both at once because plasmapheresis will take out the rituximab, but you can do them in sequence and that may be a good plan, although I don;t think it has been tried very often.

So RTX gets rid of all autoimmune antibodies or only if they are in the B cells?

Plamapheresis is the choice of Dr Angela Vincent who knows a lot about the rare autoimmune diseases with antibodies to nervous system antigens - where you want quick improvement.

Sorry for not knowing this, but who is Dr. Angela Vincent?

ETA: I just Googled her and her bio says she is focused on "auto-antibody mediated ion channel and receptor disorders" which I assume relates to my issue (n-type calcium channel antibodies.) I wonder if there are specialist in the US with this interest since she is in the UK.
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Thank you and I was curious, is it a one time treatment or something that people have to do weekly like dialysis?

So RTX gets rid of all autoimmune antibodies or only if they are in the B cells?

Sorry for not knowing this, but who is Dr. Angela Vincent?
ETA: I just Googled her and her bio says she is focused on "auto-antibody mediated ion channel and receptor disorders" which I assume relates to my issue (n-type calcium channel antibodies.) I wonder if there are specialist in the US with this interest since she is in the UK.

People tend to have a series of plasmapheresis treatments over a few weeks and then move on to some other maintenance therapy. It is not practical to keep doing it like dialysis.

RTX gets rid of all autoantibodies that are made by relatively short lived plasma cells (matured B cells). If the antibodies are made by long lived plasma cells, as for some lupus antibodies, the effect is probably less.

Dr Vincent is a world authority on ion channel autoimmunity but there will be experts in the US.
 

Gingergrrl

Senior Member
Messages
16,171
People tend to have a series of plasmapheresis treatments over a few weeks and then move on to some other maintenance therapy. It is not practical to keep doing it like dialysis.

Thanks for clarifying.

RTX gets rid of all autoantibodies that are made by relatively short lived plasma cells (matured B cells). If the antibodies are made by long lived plasma cells, as for some lupus antibodies, the effect is probably less.

Is there a way to determine with a specific antibody if it is in the short-lived plasma/B cells versus the long-lived plasma cells like lupus antibodies?

Dr Vincent is a world authority on ion channel autoimmunity but there will be experts in the US.

Do you think she would know of someone in the US or do you know of anyone?
 

Jonathan Edwards

"Gibberish"
Messages
5,256
Thanks for clarifying.

Is there a way to determine with a specific antibody if it is in the short-lived plasma/B cells versus the long-lived plasma cells like lupus antibodies?

Do you think she would know of someone in the US or do you know of anyone?

The likely plasma cell lifespan can only really be assessed based on results from rituximab usage. We know the life spans for a lot of common autoantibodies for that reason. I do not know if there is any information on the ones you are interested in specifically. In terms of US specialists, I suspect the best thing is to find out who has published (on PubMed) on the antibodies of interest to you - or ask your physician to check it out.
 

Gingergrrl

Senior Member
Messages
16,171
@Jonathan Edwards I have one more question for you! If someone were to do IVIG and plasmapheresis, would they counteract each other? Meaning would the IVIG put the antibodies in your blood stream and then the plasmapheresis would remove them?! How far apart would these two treatments need to be and in which order?
 

Jonathan Edwards

"Gibberish"
Messages
5,256
@Jonathan Edwards I have one more question for you! If someone were to do IVIG and plasmapheresis, would they counteract each other? Meaning would the IVIG put the antibodies in your blood stream and then the plasmapheresis would remove them?! How far apart would these two treatments need to be and in which order?

Plamapheresis includes taking out you rpasma, including your Ig and replacing it with other people's plasma, including Ig. So it sort of includes IVIg. Giving IVIg as well would seem a waste of time. I have never heard of it being done. To be honest the chances of IVIg doing anything much in a situation where it has not been properly trialled are pretty close to zero I would say. In the one condition where it does seem to work, immune thrombocypenia, there may well be a unique mechanism relating to antibody binding to platelets.