Modulation of Cytokines and Immune Cells by Plasma Exchange in Patients With Certain Autoimmune Neurological Diseases.

OBJECTIVE

Therapeutic plasma exchange (TPE) plays a crucial role in the management of autoimmune neurological disorders, although its effects on cytokines and immune cells are not fully understood. This study aimed to investigate the impact of TPE on immune cell subsets, cytokine levels, and immunoglobulins.

METHODS

A total of 85 patients with certain autoimmune neurological disorders underwent TPE, during which laboratory markers and complications were monitored. Blood and cerebrospinal fluid (CSF) samples were collected before and after TPE to assess changes in immunoglobulins, lymphocyte subsets, and cytokines. Clinical outcomes were evaluated 1 month after the TPE course using the modified Rankin Scale.

RESULTS

Among 408 TPE procedures, complications were mostly mild and manageable, with no fatalities. Peripheral blood leukocyte counts increased significantly, predominantly due to neutrophil elevation. Lymphocyte subset analysis revealed an increase in the proportion of T cells and a decrease in NK cells. Cytokine analysis showed a reduction in serum levels of IL-6 and TNF-α, and a decrease in CSF levels of IL-6, IL-8, IL-10, and IFN-γ. After TPE, immunoglobulin levels (IgA, IgG, and IgM) were significantly lower in both blood and CSF.

CONCLUSION

TPE is a safe and well-tolerated procedure for patients with certain autoimmune neurological disorders, potentially promoting recovery by modulating immune cell subsets and clearing pro-inflammatory cytokines.