{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T18:56:53Z","timestamp":1791485813193,"version":"4.3.4"},"reference-count":33,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T00:00:00Z","timestamp":1760054400000},"content-version":"vor","delay-in-days":9,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82571544"],"award-info":[{"award-number":["82571544"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82171399"],"award-info":[{"award-number":["82171399"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371413"],"award-info":[{"award-number":["82371413"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2023JJ30868"],"award-info":[{"award-number":["2023JJ30868"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2023JJ40502"],"award-info":[{"award-number":["2023JJ40502"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2022JJ40724"],"award-info":[{"award-number":["2022JJ40724"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100004735","name":"Natural Science Foundation of Hunan Province","doi-asserted-by":"publisher","award":["2023JJ30062"],"award-info":[{"award-number":["2023JJ30062"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["CNS Neurosci Ther"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Lymphoplasmapheresis (LPE), an innovative hemopurification technique that integrates conventional plasma exchange (PE) with lymphopheresis, has demonstrated efficacy in various neuroimmune disorders by removing excessive or dysfunctional lymphocytes and pathological components from plasma. This study aimed to unveil the mechanisms of LPE and provide additional clinical evidence supporting its use in the acute treatment of steroid\u2010refractory NMOSD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This study included 105 acute\u2010stage steroid\u2010refractory NMOSD patients. The efficacy and potential mechanisms of LPE were clarified by monitoring severity scores, clinical laboratory parameters, immune cell subsets, and cytokine levels.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      In the retrospective cohort, LPE proved effective in treating acute steroid\u2010refractory NMOSD and was non\u2010inferior to PE. In the prospective cohort, LPE significantly decreased Expanded Disability Status Scale (EDSS) and Activities of Daily Living (ADL) scores (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05). In both cohorts, erythrocytes, hemoglobin, and platelets decreased. Notably, LPE significantly reduced the proportions of activated platelet\u2010adherent monocytes, plasmablasts, and memory B cells, while increasing that of naive CD8\n                      <jats:sup>+<\/jats:sup>\n                      T cell subsets (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Additionally, LPE significantly reduced the levels of aquaporin\u20104 antibody (AQP4\u2010Ab), fibrinogen, erythrocyte sedimentation rate, C\u2010reactive protein, complements, immunoglobulin, and proinflammatory cytokines (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      While further validation is warranted, our findings suggest that LPE could represent a potential acute\u2010phase treatment strategy for patients with AQP4\u2010Ab\n                      <jats:sup>+<\/jats:sup>\n                      NMOSD, especially in those who are refractory to corticosteroid therapy.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/cns.70628","type":"journal-article","created":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T04:43:51Z","timestamp":1760157831000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Lymphoplasmapheresis for Steroid\u2010Refractory Neuromyelitis Optica Spectrum Disorder: A Real\u2010World Multicenter Study in China"],"prefix":"10.1111","volume":"31","author":[{"given":"Qiuming","family":"Zeng","sequence":"first","affiliation":[{"name":"Department of Neurology Xiangya Hospital, Central South University  Changsha Hunan People's Republic of China"},{"name":"Clinical Research Center for Neuroimmune and Neuromuscular Disorders Xiangya Hospital, Central South University  Changsha Hunan People's Republic of China"},{"name":"National Clinical Research Center for Geriatric Disorders Xiangya Hospital, Central South University  Changsha Hunan People's Republic of 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