Kurzfassung

Therapy with plasmapheresis and intravenous application of immunoglobulins has been demonstrated to be effective in large collectives in patients with Guillain-Barré Syndrome (GBS). The rationale for the use of plasmapheresis is that antibodies against gangliosides, which are cell surface components of nerves and other tissues, are often detected in patients with GBS and it could be demonstrated, that anti-ganglioside antibodies cause motor nerve dysfunction.
A variant of plasmaphersis is the...Therapy with plasmapheresis and intravenous application of immunoglobulins has been demonstrated to be effective in large collectives in patients with Guillain-Barré Syndrome (GBS). The rationale for the use of plasmapheresis is that antibodies against gangliosides, which are cell surface components of nerves and other tissues, are often detected in patients with GBS and it could be demonstrated, that anti-ganglioside antibodies cause motor nerve dysfunction.
A variant of plasmaphersis is the selective immunoadsorption, that removes only antigens (antibodies), instead of whole plasma. During the immunoadsorption, plasma is separated from cellular components, the plasma is then passed through exchange columns that will remove immunglobulines (including the autoantibodies) by adsorption to the column and then the plasma will be returned to the previous separated cellular components of the blood and then to the patient. Thus, the use of immunoadsorption does not require a blood substitution, such as fresh frozen plasma or albumin, which carries a risk of infection or an allergic reaction. Moreover, we do not know the effects of blood substitution on the immune system (leukocyte phenotypes, cytokine expression, complement activation) during autoimmune disease.
Therefore, on the basis of the concept of a pathophysiological relevance of autoantibodies in GBS/ (autoimmune Encephalitis) and the known capacity of immunoadsorption to effectively reduce high titres of circulating antibodies (up to 90%), we want to investigate the clinical efficacy, safety, and immunologic effects of immunoadsorption in GBS and (autoimmune Encephalitis) patients as an alternative to the classically used plasmaheresis.
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