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Immunoadsorption therapy has become popular for the treatment of various autoimmune diseases as the number of clinically available immunoadsorption columns increases. Immunoadsorption columns for plasma perfusion or direct hemoperfusion available for clinical use such as the Immusorba TR and PH, Selesorb, Prosorba, Immunosorba, Ig-Therasorb, and Medisorba MG are reviewed in the first part of this article. The peptide columns which immobilize peptides as the ligands are described in the second half. The peptide column has the potential to deliver specific adsorbents if a peptide is appropriately designed to remove the pathogenic substances specifically responsible for the given disease.

A non-machinery-based system for the reinfusion of ascitic fluid was developed and assessed. In fundamental studies utilizing bovine serum, this procedure proved economical, quick and useful. The most suitable filter was PS-R (#405-2). Bovine serum with a protein concentration below 3.0 g/dl was treated using this system. Samples containing blood (prepared to 0.5% hematocrit) were also treated, but the treatment time required was double that of serum with the same protein concentration. In both cases the protein recovery ratios were about 90%. We conducted clinical studies on 62 occasions (machinery-based system; 31 times, non-machinery-based system; 31 times) on 19 cases of ascites refractory to treatment with various drugs including diuretics. Clarification of the differences between the non-machinery and the machinery-based system, indicated the former to be superior. This new procedure is easier because of its use of no machinery, and the high protein recovery ratio proved its usefulness.

BACKGROUND & AIMS:Epidemiological and experimental studies have shown that dietary fiber may prevent colon cancer. Resistant starch, like dietary fiber, is not subject to digestion in the small intestine. However, it is unknown whether resistant starch inhibits colonic carcinogenesis. In vitro studies have shown that butyrate slows the growth of cultured colon cancer cells. The effect of resistant starch diet on 1,2-dimethylhydrazine-induced colonic carcinogenesis in rats was evaluated, and the colonic butyrate concentration was measured. METHODS:Sprague-Dawley rats were randomly divided into five groups that were fed diets containing no fiber, 3% cellulose, 10% cellulose, 3% resistant starch, or 10% resistant starch. Colonic carcinogenesis and butyrate concentration of colonic contents and feces in each diet group were compared. RESULTS:Total cancer volume per rat in the 10% cellulose group was significantly lower than that in the basal group (109 +/- 54 mm3 and 247 +/- 83 mm3; P < 0.05), but the other groups showed no significant differences. The butyrate concentration in colonic content and in feces were higher in the resistant starch groups than in the cellulose groups. CONCLUSIONS:The resistant starch diet increased butyrate concentration but did not inhibit colonic carcinogenesis. It remains doubtful whether butyrate inhibits the proliferation of colon cancer cells. (Gastroenterology 1996 Jan;110(1):116-20)

The prevalence of cigarette smoking among Japanese men has been consistently high compared with Western males over the past 30 years. However, during the same period, the incidence of and mortality rates for lung cancer have consistently been lower in Japan than in Western countries (‘Japanese smoking paradox’). The odds ratio/relative risk of cigarette smoking for lung cancer mortality/incidence relative to the same number of cigarettes smoked per capitain Japan, were apparently lower than those in Western countries. This must be the cause driving the ‘Japanese smoking paradox’. Furthermore, low carcinogenic ingredients in Japanese cigarettes and a congenitally-related resistance to smoking-related lung carcinogenesis emerged as the main factors which have brought the ‘Japanese smoking paradox’.

INTRODUCTION
Guest Editor's Introduction: The most specific adsorption of antibody can be achieved by the application of antigen-antibody binding. The antibody is specific for a particular part of antigen called epitope rather than for the whole antigen molecules. Therefore, the immobilized epitope for target antibody could be used as the ligand of the adsorbent. Kuraray Co. developed a specific adsorbent for the anti-acetylcholine receptor antibody. The adsorbent consists of microporous cellulose beads for the base material which immobilized a synthetic peptide as the epitope ligand. This paper describes the basic design and in vitro characteristics of the adsorbent. This paper was printed in Therapeutic Plasmapheresis, vol 12, page 573-576 (1993), and reprinted here with permission.

Abstract: We have developed Medisorba MG, a new immunoadsorbent column for myasthenia gravis (MG). The a 183–200 segment of the Torpedo Californicaacetylcholine receptor (AChR) is recognized as the acetylcholine binding site by the blocking antibody, which is one of the anti‐AChR antibodies involved in the pathogenesis of MG. As a specific affinity ligand to remove the blocking antibody, Torpedoα 183–200 was synthesized and immobilized covalently to porous cellulose beads. This immunoadsorbent showed specific removal of the blocking antibody without reducing IgG and albumin levels significantly in clinical evaluation and in vitro study. Clinical improvement was found in 78% of the cases, and no adverse effects were observed in any case. The Medisorba MG column has been confirmed as a useful device for the treatment of MG.