血球成分吸着除去療法

Cytoaphresis Therapy for Inflammatory Bowel Disease

要旨●炎症性腸疾患に対する血球成分吸着除去療法はステロイド抵抗例・依存例に対して使用されるが，近年生物学的製剤の開発に伴い，使用される症例が限定されている．一方で他の治療法と同様に内視鏡的寛解や粘膜治癒効果も確認されている．筆者は治療選択するうえで内視鏡的活動度や臨床背景を考慮して治療を決めている．血球成分吸着除去療法の好適症例は，内視鏡的に中等症の症例，広範な粘膜脱落を伴う潰瘍を要しない症例，高齢者や何らかの感染症を合併しており治療の選択において安全性が重視されるような症例などである．

　Cytoaphresis is generally used for ulcerative colitis（UC）patients with steroid-refractory and steroid-dependent diseases. Recently, several biologics have been developed for Inflammatory Bowel Disease ; therefore, the cases in which apheresis is used are limited. Contrarily, cytoapheresis has the potential to achieve endoscopic remission and mucosal healing. In the present study, the treatments for active UC were selected according to endoscopic severity and clinical background of the patients. Suitable cases for cytoapheresis include those with moderate endoscopic severity, those without wide-spread mucosal defects, elderly patients, or those with infectious diseases. Cytoapheresis might be used if safety is important for the patient.