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World J Gastrointest Pathophysiol. May 12, 2020; 11(3): 43-56
Published online May 12, 2020. doi: 10.4291/wjgp.v11.i3.43
Selective granulocyte and monocyte apheresis in inflammatory bowel disease: Its past, present and future
Xiu-Li Chen, Jing-Wei Mao, Ying-De Wang
Xiu-Li Chen, Jing-Wei Mao, Ying-De Wang, Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University, Dalian 116011, Liaoning Province, China
Author contributions: Chen XL and Mao JW performed the literature review, wrote and edited the initial manuscript; Wang YD wrote and edited the final manuscript.
Conflict-of-interest statement: Authors declare no conflict of interests for this article.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-De Wang, MD, Chief Physician, Professor, Department of Gastroenterology, the First Affiliated Hospital of Dalian Medical University, No. 222, Zhongshan Road, Xigang District, Dalian 116011, Liaoning Province, China. albertwyd@163.com
Received: December 31, 2019
Peer-review started: December 31, 2019
First decision: February 19, 2020
Revised: March 5, 2020
Accepted: April 8, 2020
Article in press: April 8, 2020
Published online: May 12, 2020
Processing time: 132 Days and 19.8 Hours
Abstract

The etiology and pathogenesis of inflammatory bowel disease (IBD), including ulcerative colitis and Crohn’s disease, are not fully understood so far. Therefore, IBD still remains incurable despite the fact that significant progress has been achieved in recent years in its treatment with innovative medicine. About 20 years ago, selective granulocyte and monocyte apheresis (GMA) was invented in Japan and later approved by the Japanese health authority for IBD treatment. From then on this technique was extensively used for IBD patients in Japan and later in Europe. Clinical trials from Japan and European countries have verified the effectiveness and safety of GMA therapy in patients with IBD. In 2013, GMA therapy was approved by China State Food and Drug Administration for therapeutic use for the Chinese IBD patients. However, GMA therapy has not been extensively used in China, although a few clinical studies also showed that it was effective in clinical and endoscopic induction of remission in Chinese IBD patients with a high safety profile. This article reviews past history, present clinical application as well as the future prospective of GMA therapy for patients with IBD.

Keywords: Inflammatory bowel disease; Ulcerative colitis; Crohn’s disease; Granulocyte and monocyte apheresis; Therapy; Efficacy

Core tip: Conventional therapies for inflammatory bowel disease (IBD) patients including mesalazine, corticosteroids, and immunosuppressants have been used for decades with unsatisfactory outcomes due to ineffectiveness or side effects. Although the emerging biologic agents have revolutionized IBD treatment, severe opportunistic infections, primary or secondary loss of response, etc. are the major clinical concerns of clinicians and patients. In recent years, selective granulocyte and monocyte apheresis has been used in Japan, Europe, China and elsewhere for its advantages of satisfactory efficacy and high safety profile. Granulocyte and monocyte apheresis therapy is an important and promising therapeutic option for IBD patients.