Preliminary Clinical Observations on the Treatment of 20 Cases of Severe Immune-Mediated Diseases Using the Combined Immune-Inflammation Adsorption System (CIAS)

Abstract

Objective: To investigate the short-term efficacy and safety of the Combined Immune-Inflammation Adsorption System (CIAS) in the treatment of severe immune-mediated diseases. Methods: A retrospective analysis was conducted on the clinical data of 20 patients with severe immune-mediated diseases treated at our hospital using CIAS, which involved a series connection of the Kangbail® Protein A Immunoadsorption Column and the Kangseitong® Hemoperfusion Device. Changes in key laboratory indicators and clinical symptoms before and after treatment were compared. Results: A total of 68 treatment sessions were completed across the 20 patients. The mean reduction in IgG levels after a single treatment was (46.2 ± 11.3)% (p < 0.01). In patients with lupus nephritis, anti-ds-DNA antibody titers decreased by (68.4 ± 15.2)%, and 24-hour urine protein levels decreased from (4.8 ± 2.1) g/day to (1.2 ± 0.7) g/day (p < 0.01); Antibody levels in patients with anti-glomerular basement membrane disease decreased significantly, with 3 cases (75%) becoming independent of dialysis; in the group of highly sensitized patients prior to kidney transplantation, the positive rate of reactive antibodies (PRA) decreased from (76.5 ± 18.3)% to (21.4 ± 12.6)% (p < 0.01), and all patients successfully underwent transplantation. Post-treatment, both IL-6 and TNF-α levels decreased by more than 50% (p < 0.05). The overall clinical remission rate was 85% (17/20), including 6/7 cases of lupus nephritis, 3/4 cases of anti-GBM disease, 3/4 cases of ANCA-associated vasculitis, and 5/5 cases of highly sensitized pre-transplant patients. The incidence of treatment-related adverse reactions was 14.7% (10/68 sessions), primarily consisting of mild hypotension, bleeding at the puncture site, and mild allergic reactions. All symptoms resolved after symptomatic treatment, and no serious complications occurred. Conclusion: CIAS demonstrates definite short-term efficacy in severe immune-mediated diseases, with good safety and manageable adverse reactions, and can serve as a rescue treatment option for patients who have not responded well to conventional drug therapy.