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Selective Apheresis of C-Reactive Protein for Treatment of Indications with Elevated CRP Concentrations

1
Pentracor GmbH, 16761 Hennigsdorf, Germany
2
iAdsorb GmbH, 10787 Berlin, Germany
3
Department of Neurology, University of Ulm, 89081 Ulm, Germany
4
Medizinische Klinik m.S. Gastroenterologie/Infektiologie/Rheumatologie, Charité Universitätsmedizin, 12203 Berlin, Germany
*
Author to whom correspondence should be addressed.
J. Clin. Med. 2020, 9(9), 2947; https://doi.org/10.3390/jcm9092947
Received: 26 August 2020 / Revised: 10 September 2020 / Accepted: 10 September 2020 / Published: 12 September 2020
(This article belongs to the Special Issue Apheresis in Neurological Disorders)
Almost every kind of inflammation in the human body is accompanied by rising C-reactive protein (CRP) concentrations. This can include bacterial and viral infection, chronic inflammation and so-called sterile inflammation triggered by (internal) acute tissue injury. CRP is part of the ancient humoral immune response and secreted into the circulation by the liver upon respective stimuli. Its main immunological functions are the opsonization of biological particles (bacteria and dead or dying cells) for their clearance by macrophages and the activation of the classical complement pathway. This not only helps to eliminate pathogens and dead cells, which is very useful in any case, but unfortunately also to remove only slightly damaged or inactive human cells that may potentially regenerate with more CRP-free time. CRP action severely aggravates the extent of tissue damage during the acute phase response after an acute injury and therefore negatively affects clinical outcome. CRP is therefore a promising therapeutic target to rescue energy-deprived tissue either caused by ischemic injury (e.g., myocardial infarction and stroke) or by an overcompensating immune reaction occurring in acute inflammation (e.g., pancreatitis) or systemic inflammatory response syndrome (SIRS; e.g., after transplantation or surgery). Selective CRP apheresis can remove circulating CRP safely and efficiently. We explain the pathophysiological reasoning behind therapeutic CRP apheresis and summarize the broad span of indications in which its application could be beneficial with a focus on ischemic stroke as well as the results of this therapeutic approach after myocardial infarction. View Full-Text
Keywords: CRP; apheresis; stroke; inflammation CRP; apheresis; stroke; inflammation
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Kayser, S.; Brunner, P.; Althaus, K.; Dorst, J.; Sheriff, A. Selective Apheresis of C-Reactive Protein for Treatment of Indications with Elevated CRP Concentrations. J. Clin. Med. 2020, 9, 2947.

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