Document 1177
 DOCN  M94A1177
 TI    Effect of total exchange transfusion (Ex-Tx) followed by CR1 rich
       erythrocyte transfusion or plasmapheresis on complement activation and
       HIV complex formation.
 DT    9412
 AU    Inada Y; Sakai K; Sulzberger J; Miyamoto K; Lange M; St.
       Luke's-Roosevelt Hop. Ctr., Columbia University, New York,; NY.
 SO    Int Conf AIDS. 1994 Aug 7-12;10(2):191 (abstract no. PB0779). Unique
       Identifier : AIDSLINE ICA10/94371398
 AB    OBJECTIVE: HIV and other antigens and their immune complexes (IC) in HIV
       infected patients could have an important amplifying role in chronic
       complement and lymphocyte/monocyte activation resulting in proliferation
       and multiplication of HIV. We attempted to improve the erythrocyte
       (E)-CR1 IC clearing system for the possible delay of progression of HIV
       disease. METHODS: AIDS patients were enrolled and received 3 total Ex-Tx
       (every 4 wks) and followed by; 1) 2-4 units of packed E with high CR1
       function (Grp-1, every 4-8 wks) or 2) plasmapheresis (Grp-2, every 2
       wks). Follow up included periodic measurements of complement split
       products (CSP: CSb-9, Bb), CRP and HIV IC isolated from E surfaces.
       RESULTS: In the patients with long term observation (20 mo), the levels
       of CSPs and CRP were reduced and/or kept at low concentrations as was
       anti-HIV antibody decrived from IC bound to E as seen in asymptomatic
       HIV(+) individuals. These observations were accompanied by an increase
       of E-CR1 IC clearing ability. However, E-CR1 IC clearing system
       gradually decreased within 2-4 month with appearance of IgG on E
       surfaces in Grp-1. CONCLUSIONS: As previously reported, saturation of
       E-CR1, raising of CRP and HIV complex levels were associated with
       progressing HIV disease. Our observation to date suggested that
       increased HIV complexes and decreased E-CR1 IC clearing system can be
       partially improved by Ex-Tx with high CR1 bearing E. However, subsequent
       regular Tx or plasmapheresis could not maintain E-CR1 IC clearing
       ability. A possible delay in progression of HIV diseases may be achieved
       by preventing saturation of E-CR1 IC clearing system by frequent Ex-Tx
       such as every month.
 DE    Acquired Immunodeficiency Syndrome/BLOOD/IMMUNOLOGY/*THERAPY
       Antigen-Antibody Complex/BLOOD  Comparative Study  *Complement
       Activation  Complement Membrane Attack Complex/ANALYSIS  *Erythrocyte
       Transfusion  *Exchange Transfusion, Whole Blood  Follow-Up Studies
       Human  HIV Antibodies/*BLOOD  *Plasmapheresis  Time Factors  CLINICAL
       TRIAL  MEETING ABSTRACT

       SOURCE: National Library of Medicine.  NOTICE: This material may be
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