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Functionalized hollow fiber membrane cartridge for adsorption of Anticofactor/Antiphospholipid antibodies: a potential tool for treatment.

It is of considerable interest to ascertain whether a hollow fiber cartridge containing histidine immobilized on polyethylenevinyl alcohol membrane (His-PEVA) is able to retain specific autoantibodies involved in antiphospholipid syndrome. To this end diluted patient pathogenic plasma containing high levels of anti-beta2-glycoprotein I (anti-beta2GPI) and antiprothrombin antibodies was processed through the functionalized cartridge. The adsorbed material was then eluted under mild conditions and analyzed; an enrichment of the eluted fractions in total IgG and more specifically in IgG2 subclass was observed, compared with the injected sample. Enzyme-linked immunosorbent assay tests showed a higher specific binding of antiprothrombin and anti-beta2GPI in these fractions. This was in accordance with the concomitant higher anticoagulant activity measured on the same fractions. All in vitro results clearly demonstrated the ability of the His-PEVA cartridge to preferentially adsorb these autoantibodies. Hence the functionalized cartridge represents a potential tool for the treatment of antiphospholipid syndrome by selective extracorporeal removal of IgG.