β2-microglobulin-selective direct hemoperfusion column for the treatment of dialysis-related amyloidosis

Lixelle is a direct hemoperfusion-type adsorption column that was developed to selectively eliminate beta(2)-microglobulin (beta(2)-m) from the circulating blood of patients with dialysis-related amyloidosis (DRA). The adsorbent in Lixelle comprises porous cellulose beads to which hydrophobic hexadecyl alkyl chain is covalently bound. One milliliter of wet Lixelle beads eliminates more than 1 mg of beta(2)-m in vitro. In hemodialysis patients who were treated with Lixelle, Lixelle improved joint pain, nocturnal awakening, pinch strength, motor terminal latency, and their activity of daily living. The adsorbent adsorbs beta 2-m selectively but not specifically, as well as inflammatory cytokines such as interleukin-1 beta and IL-6 which are considered to be involved in the development of DRA. Lixelle treatments reduce the circulating levels of beta 2-m and inflammatory cytokines, thereby improving the symptoms of patients with DRA. (c) 2005 Elsevier B.V. All rights reserved.