#100- Dr. Carley Squires discusses Therapeutic Plasma Exchange (TPE)

<p>In this episode of the <strong>Neuroveda Podcast for Complex Health</strong>, Gillian Ehrlich, ARNP, sits down with <strong>Dr. Carley Squires</strong> to discuss <strong>apheresis</strong>, with a focus on <strong>therapeutic plasma exchange (TPE)</strong>, also known as <strong>plasmapheresis</strong>.</p><p>Apheresis means the removal of something from the blood, and the type of apheresis depends on what is being removed. At Neuroveda, the focus is <strong>plasma apheresis</strong>, meaning plasma is removed and replaced with albumin and saline. Therapeutic plasma exchange is an extracorporeal blood purification technique designed to remove a portion of plasma that may contain potentially harmful substances such as <strong>autoantibodies, inflammatory cytokines, immune complexes, and other immune mediators</strong> involved in immune dysregulation.</p><p>Dr. Squires explains the broader umbrella of therapeutic apheresis, including <strong>red blood cell exchange, leukapheresis, plateletpheresis, lipid/LDL apheresis, extracorporeal photopheresis, and H.E.L.P. apheresis</strong>. While H.E.L.P. apheresis is not currently available in the United States, interest in apheresis expanded during the rise of <strong>long COVID</strong>, when patients began traveling internationally for treatment.</p><p>Therapeutic plasma exchange has been used for decades in hospital settings, primarily for <strong>autoimmune disease</strong>, but is now being explored for additional applications including <strong>long COVID, neuroinflammatory conditions, and longevity medicine</strong>. Research suggests TPE may help support immune modulation through mechanisms such as:</p><p>• Removal of immune complexes<br>• Reduction of inflammatory cytokines<br>• Correction of altered <strong>Th1/Th2 immune balance</strong><br>• Increased <strong>T regulatory and T suppressor cells</strong></p><p>Emerging research has also explored TPE for <strong>PANDAS/PANS</strong>, pediatric autoimmune neuropsychiatric disorders triggered by infection.</p><p>References<br><a href="https://www.sciencedirect.com/science/article/pii/S0149763417305833" target="_blank" rel="ugc noopener noreferrer">https://www.sciencedirect.com/science/article/pii/S0149763417305833</a><br><a href="https://pubmed.ncbi.nlm.nih.gov/10513708/" target="_blank" rel="ugc noopener noreferrer">https://pubmed.ncbi.nlm.nih.gov/10513708/</a></p><p>While additional research is still needed for many of these applications, Neuroveda has