To examine the possible effect of plasmapheresis on the ratio of Th1/Th2 type cytokine-secreting
cells we recruited eight patients with active systemic lupus erythematosus into the
present study. They all failed to respond to conventional therapy. A sensitive multiparametric
flow cytometric analysis was used for the detection of intracellular IL-4, IL-10 and
IFNgamma. Stimulated peripheral blood cells were analysed by this procedure. Plasmapheresis
was performed every second day for three occasions, using a continuous flow type blood
cell separator, and a total of 100 ml/body weight kg plasma was removed. Patients
received 1 mg/kg/day methylprednisolone during this period. As a result of the procedure,
the rate of IFNgamma positive Th cells increased, while the rate of IL-4 and IL-10
expressing CD4 positive cells decreased. Together with these observations the concentration
of anti-ds-DNA antibodies decreased after plasmapheresis. A decrease in disease activity
index (SLE-DAI) indicated the clinical effectiveness of the therapy.
