Immune adsorption for the treatment of fatigue-dominant long-/post-COVID syndrome—a case series [...], 2023, Ruhe et al

Immune adsorption for the treatment of fatigue-dominant long-/post-COVID syndrome—a case series of standardized individual experimental therapy

Research letter / case series of 10 patients.

Announced English version not published yet.

So in lieu of an abstract here's a google translate link for now.


Google translate:

A relevant proportion of patients suffer from fatigue-dominant long/post-COVID syndrome after SARS-CoV-2 infection. Elevated levels of autoantibodies (AAK) against G protein-coupled neurotransmitter receptors (including β-adrenergic and muscarinic) were detected in 57% of those affected by long-term/post-COVID treatment at university ( 1 ) .

In patients with myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), the reduction of β-adrenergic AAK by means of immunoadsorption was associated with clinical improvement ( 2).

Reports on individual treatment successes with apheresis procedures for long-/post-COVID are increasingly being propagated via social media. However, cases or studies with negative results receive the necessary attention much less frequently. In view of the insufficient overall data available to date, professional societies are calling for a broader scientific basis, to which we would like to contribute with this case series.

[...]

From the results section:

[...] In the follow-up, the GPCR-AAK were still lower than the baseline level, but were mostly detectable again above the reference value (β 1 [8/10 study participants], β 2 [9/10], M 3 [7/10] and M 4[6/10]).

At the same time, no clinically relevant change in mental and physical health compared to the initial findings could be determined either after the immune adsorption cycle or during follow-up (Table) . The health-related quality of life (EQ-5D) and subjective satisfaction of the study participants improved marginally at best (table) .


Citation:

Ruhe J, Giszas B, Schlosser M, Reuken PA, Wolf G, Stallmach A: Immune adsorption for the treatment of fatigue-dominant long-/post-COVID syndrome—a case series of standardized individual experimental therapy. Dtsch Arztebl Int 2023; 120. DOI: 10.3238/arztebl.m2023.0073

Link to the German full text here.

 

They are using LIFE21 apheresis unit mentioned in the article posted above.

The company lists several related units on their website:

https://www.miltenyibiotec.com/BE-en/products/life-21-apheresis-unit.html#330-000-621

 

Apheresis for moving antibodies (as described here) usually uses a filter/adsorbing column based on a bacterium-derived antibody scavenging protein like Staph protein A. It specifically moves antibody a bit like an ion exchange resin removes specific salts. Old fashioned plasmapheresis I think just removed plasma protein fairly non-specifically.

 

https://twitter.com/user/status/1697934275830559013


Very Similar study Preprint
With Scheibenbogen involved.
10 patients with 7 responders

What is mostly (temporarily) help earlier stage ME CFS?
Or also benefit for late stage, more severe ME CFS?

there is the anecdotal improvement of the (very) severe German patient Faraz Fallahi - you can read on Twitter / X