Background/Aims: The aim of this study was to determine whether treatment with β2-microglobulin adsorption column (Lixelle) affects bone cysts and clinical symptoms in patients with dialysis-related amyloidosis (DRA). Methods: Radiographic changes in the number and area of bone cysts of the wrist and the hip joint were compared between 39 hemodialysis (HD) patients treated with Lixelle (Lixelle group) and 28 HD patients treated with conventional therapy as retrospective control (HD group). Clinical symptoms of DRA were also evaluated. Results: In the Lixelle group, the number of bone cysts and the cystic area in wrist joints were significantly decreased, although the changes in these parameters in hip joints were not significant. In the HD group, the corresponding parameters in the hip joints even significantly increased. Clinical symptoms notably improved after Lixelle treatment. Conclusion: Treatment with Lixelle reduces the radiolucency of bone cysts in the wrist joints, and improves clinical symptoms associated with DRA.

1.
Gejyo F, Yamada T, Odani S, Nakagawa Y, Arakawa M, Kunitomo T, Kataoka H, Suzuki M, Hirasawa Y, Shirahama T: A new form of amyloid protein associated with chronic hemodialysis was identified as β2-microglobulin. Biochem Biophys Res Commun 1985;129:701–706.
2.
Furuyoshi S, Nakatani M, Taman J, Kutsuki H, Takata S, Tani N: New adsorption column (Lixelle) to eliminate β2-microglobulin for direct hemoperfusion. Ther Apher 1993;2:13–17.
3.
Kutsuki H: β2-Microglobulin-selective direct hemoperfusion column for the treatment of dialysis-related amyloidosis. Biochim Biophys Acta 2005;1753:141–145.
4.
Gejyo F, Kawaguchi Y, Hara S, Nakazawa R, Azuma N, Ogawa H, Koda Y, Suzuki M, Kaneda H, Kishimoto H, Oda M, Ei K, Miyazaki R, Maruyama H, Arakawa M, Hara M: Arresting dialysis-related amyloidosis: a prospective multicenter controlled trial of direct hemoperfusion with a β2-microglobulin adsorption column. Artif Organs 2004;28:371–380.
5.
Abe T, Uchita K, Orita H, Kamimura M, Oda M, Hasegawa H, Kobata H, Fukunishi M, Shimazaki M, Abe T, Akizawa T, Ahmad S: Effect of β2-microglobulin adsorption column on dialysis-related amyloidosis. Kidney Int 2003;64:1522–1528.
6.
Homma N, Gejyo F, Hasegawa S, Teramura T, Ei I, Maruyama H, Arakawa M: Effects of a new adsorbent column for removing beta-2-microglonulin from circulating blood of dialysis patients. Contrib Nephrol 1995;112:164–171.
7.
Gejyo F, Amano I, Nakazawa R, Anzai T, Itami N, Inoue S: Clinical evaluations of β2-microglobulin adsorbing Lixelle columns; S-15 and S-35 – a multi-center study (Summary in English). J Jpn Soc Dial Ther 2003;36:117–123.
8.
Nakazawa R, Azuma N, Suzuki M, Nakatani M, Nankou T, Furuyoshi S, Yasuda A, Takata S, Tani N, Kobayashi F: A new treatment for dialysis-related amyloidosis with β2-microglobulin adsorption column. Int J Artif Organs 1993;16:823–829.
9.
Pincus T, Summey JA, Soraci SA Jr, Wallston KA, Hummon NP: Assessment of patient satisfaction in activities of daily living using a modified standard health assessment questionnaire. Arthritis Rheum 1983;26:1346–1353.
10.
Miyata T, Inagi R, Iida Y, Sato M, Yamada N, Oda O, Maeda K, Seo H: Involvement of β2-microglobulin modified with advanced glycation end products in the pathogenesis of hemodialysis-associated amyloidosis. Induction of human monocyte chemotaxis and macrophage secretion of tumor necrosis factor-α and interleukin-1. J Clin Invest 1994;93:521–528.
11.
Sabokbar A, Crawford R, Murray DW, Athanasou NA: Macrophage-osteoclast differentiation and bone resorption in osteoarthrotic subchondral acetabular cysts Acta Orthop Scand 2000;71:255–261.
12.
Balint E, Marshall CF, Sprague SM: Role of interleukin-6 in β2-microglobu in-induced bone mineral dissolution. Kidney Int 2000;57:1599–1607.
13.
Kazama JJ, Yamamoto S, Takahashi N, Ito Y, Maruyama H, Narita I, Gejyo F: A β2M-amyloidosis and related bone disease. J Bone Miner Metab 2006;24:182–184.
14.
Aoike I, Gejyo F, Arakawa M: Learning from the Japanese registry: how will we prevent long-term complications? Nephrol Dial Transplant 1995;10:7–15.
15.
Küchle C, Fricke H, Held E, Schiffl H: High-flux hemodialysis postpones clinical manifestation of dialysis-related amyloidosis. Am J Nephrol 1996;16:484–488.
16.
Schiffl H, Fischer R, Lang SM, Mangel E: Clinical manifestation of AB-amyloidosis: effects of biocompatibility and flux. Nephrol Dial Transplant 2000;15:840–845.
17.
Jadoul M, Noel H, Malghem J, Galant C, van Ypersele de Strihou C: Histological beta-2-microglobulin amyloidosis 10 years after a successful renal transplantation. Am J Kid Dis 1996;27:888–890.
18.
Jadoul M, Malghem J, Pirson Y, Maldague B, van Ypersele de Strihou C: Effect of renal transplantation on the radiological signs of dialysis amyloid osteoarthropathy. Clin Nephrol 1989;32:194–197.
19.
Mourad G, Argilés A: Renal transplantation relieves the symptoms but does not reverse β2-microglobullin amyloidosis. J Am Soc Nephrol 1996;7:798–805.
20.
Tan SY, Irish A, Winearls CG, Brown EA, Gower PE, Clutterbuck EJ, Madhoo S, Lavender JP, Pepys MB, Hawkins PN: Long term effect of renal transplantation on dialysis-related amyloid deposits and symptomatology. Kidney Int 1996;50:282–289.
21.
Tsuchida K, Takemoto Y, Nakamura T, Fu O, Okada C, Yamagami S, Kishimoto T: Lixelle adsorbent to remove inflammatory cytokines. Artif Organs 1998;22:1064–1069.
22.
Tsuchida K, Takemoto Y, Sugimura K, Yoshimura R, Nakatani T: Direct hemoperfusion by using Lixelle® column for the treatment of systemic inflammatory syndrome. Int J Molecul Med 2002;10:485–488.
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