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In Japan, immunoadsorption (IA) is performed using a conventional plasma separator and Immusorba TR-350 column (TR-350) for the treatment of neurological immune diseases. By this method, TR-350 has the limited maximal capacity of the immunoglobulin G (IgG) adsorption, and fibrinogen (Fbg) is reduced remarkably. Evacure EC-4A10 (EC-4A) is a selective plasma separator and the sieving coefficients of IgG and Fbg using EC-4A were 0.5 and 0, respectively. Here, we investigated the removal characteristics of IgG and Fbg in IA by TR-350 using two different plasma membrane separators: conventional plasma separator (PE-IA) and EC-4A (EC-IA). In vitro filtration using plasma effluent was performed with a closed circuit. When the processed volume was 3 L, estimated removal amounts by PE-IA were 3172 mg for IgG and 3329 mg for Fbg, respectively. When the processed volume was 3 L, estimated removal amounts by EC-IA were 4946 mg and 1916 mg, respectively. EC-IA can be considered useful for the removal of IgG, including auto-antibodies, while retaining Fbg, thereby allowing even daily use.
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Ohkubo et al. (2016) studied this question.
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