Table 1.
Main drivers of the mechanism of action of granulocyte/monocytapheresis
Within the apheresis filter
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In the patient’s bloodstream
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(1) Absorption of circulating IgG and immunocomplexes by cellulose beads; (2) Activation of complement fragments (C3a, C5a); (3) Granulocyte and monocyte absorption via Fc𝛾 receptors (IgG and immunocomplexes), and binding sites of leukocyte complement receptors (not in lymphocytes); and (4) Generation of apoptotic cells | (1) Reduction of activated neutrophils and pro-inflammatory monocytes (CD14+CD16+); (2) Apoptotic cells interact with regulatory B-cells, producing IL-10 and mature regulatory B-cells; and (3) Return of substances released by adsorbed cells: IL-1ra and HGF |
IgG: Immunoglobulin G; IL: Interleukin; HGF: Hepatocyte growth factor.