Reeves, Hollie M.

SummaryThe initial description of therapeutic plasma exchange (TPE) in an animal model was published almost 100 years ago. Since that time, this treatment has been applied to a wide variety of diseases but limited research has been published examining the mechanisms of action ofTPE. The therapeutic effects ofTPEcould include the removal of pathological substances from the blood, such as monoclonal paraproteins and autoantibodies, as well as the replacement of deficient plasma components when plasma is used as a replacement fluid. Beyond these potential mechanisms, other possible mechanisms include possible alterations in lymphocyte proliferation and function that could sensitize these cells to immunosuppressant and chemotherapeutic agents and alterations in the immune system including changes inBandTcell numbers and activation, increasedTsuppressor function, and alteration inT‐helper cell type 1/2 (Th1/Th2) ratio. Much remains unknown about the mechanisms of action ofTPE, indicating a need for basic research into this therapy.