Major research efforts are directed toward looking at factors in the blood that are believed to be involved in the development of arthritis and specifically in the development of rheumatoid arthritis and Systemic Lupus Erythematosus (SLE).

A recent approach to treating arthritis in some research centers has involved replacing certain components of the blood. Immune factors battling body tissue cause debris that builds up in the blood and leads to inflammation associated with arthritis. For several years researchers have experimented with a process called plasmapheresis. In this process some of the patient’s plasma is removed and replaced with fresh donor plasma. Plasmapheresis has produced varying results in patients. However, the limited supply of donor plasma, along with the high cost of replacing the blood supply several times a week over a period of weeks, made plasmapheresis impractical for a disease as widespread as arthritis.

Head of an arthritis research team at the Cleveland Clinic Foundation, Cleveland, Ohio, summed up some of the problems involved, with plasmapheresis: “Our best information is that it is effective in the treatment of rheumatoid arthritis and it is incredibly expensive. Most of the cost is in blood donor proteins. We generate 4 million units of donor blood in the United States each year. There are 7 million people with rheumatoid arthritis. It’s just not possible to do plasmapheresis on very many.”

Now a newer process, based on plasmapheresis, may hold more promise. Called selective apheresis, the process removes the blood and, instead of replacing it with new blood, filters it through an elaborate machine somewhat similar to a kidney dialysis machine. The blood is cleaned of possibly detrimental substances and then returned to the patient. While the process is costly, it prevents the additional expense of scarce donor blood.

According to experts after a series of selective apheresis treatments termed cryofiltration, the majority of patients tested experienced remissions or marked improvement in their conditions. Some remissions lasted up to several months. Because results with apheresis have been so encouraging, researchers believe the process will soon move out of the experimental stage into approved usage. The clinical trials of the technique were directed by the Cleveland Clinic’s team at several major health centres in the United States and Canada. Data from Tokyo and Munich have been consistent with data obtained by the Cleveland Clinic researchers and their affiliates.

Adaptations of the apheresis technique may apply to other diseases by extra-corporeal therapy. We hope to develop an immunochemical sorbent to remove from the body what we perceive as abnormal. This is theoretically possible, perhaps in a number of years.”