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      Effects of Direct Hemoperfusion with a β 2-Microglobulin Adsorption Column on Hypercytokinemia in Rats

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          Abstract

          Background/Aim: Blood purification therapies have been clinically applied to treat the cytokine-induced pathological responses. The effects of direct hemoperfusion(DHP) with a β<sub>2</sub>-microglobulin (BMG) adsorption column on hypercytokinemia were investigated. Methods: A hypercytokinemia model was prepared by injecting lipopolysaccharide (LPS) into femoral veins of male Wistar rats weighing 250–400 g. The hypercytokinemic rats were connected to the DHP system using a small BMG adsorption column, and time course changes in plasma levels of inflammatory cytokines were then examined. Results: Plasma levels of interleukins (IL) 1β and 6 and tumor necrosis factor alpha (TNF-α) were found to be significantly elevated within 3 h after LPS injection in the control group that underwent extracorporeal circulation without the BMG adsorption column, whereas the increases in plasma levels of IL-6 and TNF-α were significantly inhibited in the group that was treated with the BMG adsorption column. The adsorption rates of cytokines with the BMG adsorption column were 20–40% for IL-1β and IL-6 and 10–85% for TNF-α during treatment for 3 h. Conclusions: These results suggest that the systemic inflammatory response syndrome with hypercytokinemia might be treated with DHP using the BMG adsorption column.

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          Most cited references 7

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          Anti-inflammatory therapies to treat sepsis and septic shock

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            Cytokine receptor signaling pathways

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              Is There a Future for Adsorption Techniques in Sepsis?

              During sepsis toxins released from, e.g., bacteria induce reactions of various cascade systems that may cause progression of the patient into septic shock, disseminated intravascular coagulation, multiorgan dysfunction syndrome and subsequent death. The use of conventional treatments using antibiotics, fluid substitution, inotropic drugs, respiration aid and dialysis is not enough to reverse the serious prognosis. The addition of various other drugs such as antibodies against various cytokines and cytokine receptors, pentoxiphylline, immunoglobulins or high doses of steroids is usually without benefit for the prognosis of the patient. Another possibility to reduce the extent of toxins and other harmful compounds in the circulation is the use of apheresis (removal by technical devices). This can be done either in a nonselective way (plasma exchange, plasmapheresis) or more selectively using various adsorbers such as polymyxin B. The survival in studies varies between 50 and 80%. Besides the use of nonselective apheresis, the development of various selective adsorption techniques may be one approach to improve survival of these severely ill patients.
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                Author and article information

                Journal
                BPU
                Blood Purif
                10.1159/issn.0253-5068
                Blood Purification
                S. Karger AG
                0253-5068
                1421-9735
                2003
                2003
                26 February 2003
                : 21
                : 2
                : 145-151
                Affiliations
                Department of Urology and Division of Artificial Kidney, Osaka City University Medical School, Osaka, Japan
                Article
                69152 Blood Purif 2003;21:145–151
                10.1159/000069152
                12601256
                © 2003 S. Karger AG, Basel

                Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

                Page count
                Figures: 8, References: 17, Pages: 7
                Product
                Self URI (application/pdf): https://www.karger.com/Article/Pdf/69152
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