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      Cytokine Adsorptive Property of Various Adsorbents in Immunoadsorption Columns and a Newly Developed Adsorbent: An in vitro Study

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          Background/Aims: Cytokines play important roles in the pathophysiology of systemic inflammatory response syndrome (SIRS) and sepsis. Therefore, some effective measures to remove cytokines from the bloodstream could be effective in the treatment of SIRS and sepsis. The aim of this study was to evaluate the cytokine adsorptive property of various adsorbents for the purpose of the development of new selective cytokine adsorption columns. Methods: The cytokine adsorptive property of adsorbent in a CF-X column, which consists of cellulose beads cross-linked with hexamethylene-di-isocyanate, was compared with those of various adsorbents in currently available immunoadsorption columns, such as Immusorba TR<sup>®</sup>, Immusorba PH<sup>®</sup>, Selesorb<sup>®</sup>, and Lixelle<sup>®</sup>, in vitro batchwise test using patients’ plasma. A newly developed adsorbent, MPCF-X, which was modified by coating the surface of the adsorbent in CF-X with 2-methacryloyloxyethyl phosphorylcholine (MPC), was also tested for its cytokine adsorptive property. Results: The adsorbent in CF-Xshowed a significantly higher adsorption rate for TNF-α, interleukin (IL)-6 and IL-10 compared with other adsorbents (p < 0.05). Adsorbent in Lixelle<sup>®</sup> showed good affinity to TNF-α and IL-8. Especially, the adsorbent in CF-X almost completely removed TNF-α, whereas it also had considerable affinity to normal IgG. MPCF-X showed decreased affinity to IgG with considerable adsorptive properties to cytokines. Conclusion: Selective cytokine adsorption columns could be developed with improvement of currently available adsorbents. Such a new selective cytokine adsorption column could be clinically applied for the treatment of SIRS/sepsis.

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          Most cited references 21

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          American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference

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            Treating patients with severe sepsis.

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              High-volume haemofiltration in human septic shock.

              To evaluate whether high volume haemofiltration improves haemodynamics and affects serum cytokine and complement concentrations in human septic shock. Randomized cross-over clinical trial in a tertiary intensive care unit. Eleven patients with septic shock and multi-organ failure. Patients were assigned to either 8 h of high-volume haemofiltration (HVHF; 6 l/h) or 8 h of standard continuous veno-venous haemofiltration (CVVH; 1 l/h) in random order. We measured changes in haemodynamic variables, dose of norepinephrine required to maintain a mean arterial pressure greater than 70 mmHg and plasma concentrations of complement anaphylatoxins and several cytokines. An 8-h period of HVHF was associated with a greater reduction in norepinephrine requirements than a similar period of CVVH (median reduction: 10.5 vs. 1.0 microg/min; p = 0.01; median percentage reduction: 68 vs. 7%; p = 0.02). Both therapies were associated with a temporary reduction (p < 0.01) in the plasma concentration of C3a, C5a, and interleukin 10 within 2 h of initiation. HVHF was associated with a greater reduction in the area under the curve for C3a and C5a (p < 0.01). The concentration of the measured soluble mediators in the ultrafiltrate was negligible. HVHF decreases vasopressor requirements in human septic shock and affects anaphylatoxin levels differently than standard CVVH.

                Author and article information

                Blood Purif
                Blood Purification
                S. Karger AG
                December 2004
                07 January 2005
                : 22
                : 6
                : 530-536
                aDepartment of Emergency and Critical Care Medicine, Graduate School of Medicine, Chiba University, and bPolymer Laboratory (Chiba) Corporate Research and Development, Ube Industries, Ltd, Chiba, Japan
                82526 Blood Purif 2004;22:530–536
                © 2004 S. Karger AG, Basel

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                Figures: 3, Tables: 2, References: 27, Pages: 7
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