Immunadsorption

ZUSAMMENFASSUNG

Die aktuell zur Verfügung stehenden Aphereseformen sind wirksame und komplementäre Therapieoptionen u. a. für die Behandlung unterschiedlicher Autoimmunerkrankungen. Neben dem therapeutischen Plasmaaustausch (TPA) stellt die Immunadsorption (IA) einen wichtigen Fortschritt unserer Behandlungsmöglichkeiten dar. In vielen Bereichen der Medizin, insbesondere in der Nephrologie und Neurologie, konnten autoimmunologische Mechanismen als Auslöser zahlreicher Erkrankungen identifiziert werden. Bei vielen dieser Krankheitsbilder stellt die therapeutische Apherese (TA) eine wertvolle Therapieoption dar, insbesondere bei ausgeprägter klinischer Symptomatik oder bei therapieresistenten Verläufen. Die IA stellt inzwischen eine gute Alternative zum TPA bei einigen Indikationen dar. Als Vorteile der IA sind die potenziell selektivere Entfernung des Ziel-Immunglobulins und die Möglichkeit des höheren Plasmavolumenumsatzes zu nennen. Hierbei kann auf die Gabe von Plasma und Plasmaderivaten verzichtet werden. Als Nachteile sind meist der höhere technischer Aufwand in der Durchführung und höhere Kosten des Verfahrens zu nennen. Aktuell ist die Studienlage speziell zur IA sehr klein. Wünschenswert sind mehr klinischen Studien zur Anwendung der IA, bevor das Verfahren breite Anwendung findet.

• Literatur

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