Studies in the Development of Membrane-Based Extracorporeal Devices for the Therapeutic Management of Diseases with Circulating Pathomolecules
Extracorporeal devices [ECDs] are medical appliances placed outside the body which permit the processing of blood under controlled conditions. The extracorporeal treatment of blood can assist and support a failing organ in line with its style of functioning and thereby abort the lifethreatening consequences of the failed organ. Organ failure can be the long term consequence of circulating pathomolecules lodging in the capillary network of organs leading to a number of biological events. Circulating immune complexes (CIC), one such species of pathomolecule leading to organ failure, have been detected in the blood of patients of a number of malignancies and autoimmune diseases (Theofilopoulos & Dixon, 1979). Due to the continuous release of tumor antigens in these diseases, immune complexes are formed which later act as “blocking factors” and mask, modulate, or cause shedding of tumor associated antigens so that sensitized effector lymphocytes no longer recognise their antigenicity. Because of the critical role of CIC in the pathogenesis of lesions leading to organ failure, considerable efforts have been directed towards the development of techniques to artificially remove them from the blood, a recommended modality of therapeutic management of many of these diseases (WHO, 1977). Extracorporeal treatment of blood based on crossflow membrane filtration of blood has opened the possibility of physically manipulating the immune response (the so called ‘immunosurgery’) by removal of such CIC at the bedside thereby forming what can be termed ‘therapeutic artificial organs’.
KeywordsSystemic Lupus Erythematosus Shear Rate Cotton Fabric Hollow Fibre Growth Rate Constant
Unable to display preview. Download preview PDF.
- Bruck, S. (1980) in Evaluation of Biomaterials, Winen G.D, Leray, J.L. & Groot K. L. [Eds] 1980, John Wiley & Sons LtdGoogle Scholar
- Davis, R.H. (1992) ‘Theory of crossflow microfiltration’, in The Membrane handbook, Ho, W.S.W & Sirkar, K.K. [Eds] London, pp 484–497Google Scholar
- Dientenfass, L. (1976) in Rheology of blood in diagnostic and preventive medicine, Dintenfass, L [Ed], Butterworths, London.Google Scholar
- Cairns, S.A., London, A., Mallick, N.P. ‘The value of three immune complex assays in the mangaement of systemic lupus erythematosus: An assessment of immune complex levels, size, and immunochemical properties in relation to disease activity and manifestations’ Clin Exp Immuno L v 40 p 273 (1980)Google Scholar
- Cheryan, M. (1986) in Ultrafiltration handbook, Munir Cheryan [Ed], Technomic, Lancaster (U.S.A.) pp 67, 89.Google Scholar
- Hardin, J (1981) ‘Antigen-antibody complexes’ in Adv Immunology,Wari, D.M. [Ed], Longman Pvt Ltd, Singapore pp 366Google Scholar
- Munir Cheryan (1986) ‘Models to predict limiting flux’ in Ultrafiltration handbook, Munir Cheryan [Ed], Technomic, Lancaster (U.S.A) pp 89Google Scholar
- Saha, A., Chowdhury, P., Sambury, S., Smart, K. & Rose, B (1970) ‘Studies on Cryoprecipitation’, J. Bio L Chem., v 245 pp 2730–2736.Google Scholar
- Tung, K.S..K., DeHoratius, R.J., Williams, R.C. Jr. ‘Study of circulating immune complex size in systemic lupus erythematosus’ Clin. Exp. Immuno L v 43 p 615 (1981)Google Scholar
- WHO Technical report (1977) ‘The role of immune complexes in diseases’, Geneva.Google Scholar
- Zborowski, M. & Malchesky, P.S. (1990) “Pore size and temperature effects in membrane separation of albumin from immunoglobulin”, Trans. Am. Soc. Artif. Intern. Organs v 36: pp 730–733Google Scholar