AIM: To investigate the relationship between ulcerative colitis (UC) clinical activity index (CAI) and circulating levels of IL-1ra, IL-10, IL-6 and IL-18. METHODS: Blood levels of IL-lra, IL-10, IL-6 and IL-18 were measured in 31 patients with active UC, the mean CAI was 11.1, ranging from 5-25; and 12 healthy individuals as controls. Patients were given granulocyte and monocyte adsorptive apheresis (GMA) with Adacol-umn. Leucocytes which bear the FcyR and complement receptors were adsorbed to the column leucocytapher-esis carriers. Each patient could receive up to 11 GMA sessions over 8 wk. RESULTS: We found strong correlations between CAI and IL-10 (r = 0.827, P < 0.001), IL-6 (r = 0.785, P < 0.001) and IL-18 (r = 0.791, P < 0.001). IL-lra was not correlated with CAI. Following GMA therapy, 24 of the 31 patients achieved remission and the levels of all 4 cytokines fell to the levels in healthy controls. Further, blood levels of IL-lra and IL-10 increased at the column outflow and inflow at 60 min suggesting release from leucocytes that adhered to the carriers. CONCLUSION: Elevated blood levels of IL-6 and IL-18 together with peripheral blood granulocytes and mono-cytes/macrophages in patients with active UC show acti-vative behaviour and increased survival time can be pro-inflammatory and the targets of GMA therapy. AIM: To investigate the relationship between ulcerative colitis (UC) clinical activity index (CAI) and circulating levels of IL-1ra, IL-10, IL-6 and IL-18. METHODS: Blood levels of IL-lra, IL-10 , 12 healthy individuals as controls. Patients were given granulocyte and monocyte adsorptive apheresis (GMA) with Adacol- umn. Leucocytes which bear the FcyR and complement receptors were adsorbed to the column leucocytapher-esis carriers. Each patient could receive up to 11 GMA sessions over 8 weeks. RESULTS: We found strong correlations between CAI and IL-10 (r = 0.827, IL-6 (r = 0.785, P <0.001) and IL-18 (r = 0.791, P <0.001). IL-lra was not correlated with CAI. Following GMA therapy, 24 of the 31 patients achieved remission and the levels of all 4 cytokines fell to the levels in healthy controls. Further, blood levels of IL-lra and IL-10 increased at the column outflow and in flow at 60 min suggesting release from leucocytes that adhered to the carriers. CONCLUSION: Elevated blood levels of IL-6 and IL-18 together with peripheral blood granulocytes and mono-cytes / macrophages in patients with active UC show acti-vative behavior and increased survival time can be pro-inflammatory and the targets of GMA therapy.