Neutrophils are the most abundant population of circulating white blood cells and the host’s first line of defense against invading pathogens. Under normal conditions, circulating neutrophils have a 6–12 h half-life and are functionally quiescent. During inflammation, neutrophils arrive rapidly at the sites of infection and injury, enhance antimicrobial activity, and die within the infiltrated tissue. They play important roles in the innate immune system, and significant neutrophil responses are observed in systemic inflammation such as trauma, burn injury, sepsis, and major surgery. However, the dysregulation of neutrophil responses such as excessive or uncontrolled release of proinflammatory cytokines can cause host tissue or organ damage during severe sepsis, and autoimmune diseases. Leukocyte removal therapy (LRT), leukocytapheresis (LCAP), or granulocyte/monocyte apheresis (GMA) is a method of therapeutic apheresis that removes peripheral leukocytes by via extracorporeal circulation. It has been used as nonpharmacological treatment in ulcerative colitis (UC) and Crohn’s disease (CD), and has shown excellent short-term efficacy. LCAP using Cellsorba, a column of polyethylene telephthalate fibers (Asahi-Kasei Medical, Tokyo, Japan), has been reported to remove ~100% of granulocytes/monocytes, ~60% of lymphocytes, and ~50% of platelets from both the inlet and outlet of the Cellsorba apparatus. Although the exact mechanisms of LRT have not been fully explored, their potential mechanisms have been reported, which include a reduction in the number of activated leukocytes or proinflammatory cytokines such as tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6, and IL-8. Surgical site infection (SSI) remains one of the most common causes of morbidity in major surgery, which prolongs hospitalization and increases medical costs. The Japanese prospective multicenter surveillance showed that 19.5% of patients with UC developed SSI after surgery.

With Regards,
Sara Giselle
Associate Managing Editor
Global  Journal of Digestive Diseases