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      Call for Papers: Green Renal Replacement Therapy: Caring for the Environment

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      About Blood Purification: 3.0 Impact Factor I 5.6 CiteScore I 0.83 Scimago Journal & Country Rank (SJR)

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      Techniques of Extracorporeal Cytokine Removal: A Systematic Review of the Literature

      systematic-review

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          Abstract

          Background and Aims: Attempts at achieving cytokine homeostasis include blood purification to deliver cytokine removal. Assessment of ex vivo studies for optimal operating conditions is a vital step. Methods: We conducted a systematic search for ex vivo studies on cytokine removal using known modalities of extracorporeal circulation. We selected 29 articles and analyzed data according to clearance, sieving coefficient, ultrafiltrate concentration and percentage removal. Results: We identified four main techniques for cytokine removal: standard techniques, high cut-off (HCO) techniques, adsorption techniques and combined plasma filtration adsorption. HCO hemofiltration (HCO/HF) showed greatest consistency in cytokine removal among all approaches. Mean albumin clearance with HCO filters was 3.74 ml/min. Conclusion: Ex vivo data support the view that HCO/HF is the most consistently effective approach in terms of sieving and clearance. Further investigation of HCO/HF in randomized controlled trials in animal models and humans seems desirable.

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          Inside, outside, upside down: damage-associated molecular-pattern molecules (DAMPs) and redox.

          Anna Rubartelli, Michael T. Lotze (2007)
          Immune responses are initiated and perpetuated by molecules derived from microorganisms pathogen-associated molecular-pattern molecules or from the damage or death of host cells [damage-associated molecular-pattern (DAMP) molecules]. Many DAMPs are nuclear or cytosolic proteins with defined intracellular function that, when released outside the cell following tissue injury, move from a reducing to an oxidizing milieu resulting in their functional denaturation. Here, we discuss the consequences of DAMP oxidation on the outcome of acute inflammation. We also suggest that, outside the cell, DAMPs might adopt novel conformations or alter the redox of the extracellular environment to more closely mimic the internal one, thereby avoiding oxidation-mediated inactivation and promoting pathology. We propose that chronic inflammation associated with autoimmunity, chronic viral infection and cancer is probably mediated by persistent release and function of DAMPs, promoting and promoted by a disordered redox environment.
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            Sepsis: definition, epidemiology, and diagnosis.

            Andrew Lever, Iain S. Mackenzie (2007)
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              Confirmatory interleukin-1 receptor antagonist trial in severe sepsis

              Howard Dubin, Steven M Opal, Charles J. Fisher … (1997)
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                Author and article information

                Journal
                Journal ID (publisher-id): BPU
                Journal ID (nlm-ta): Blood Purif
                Journal ID (doi): 10.1159/issn.0253-5068
                Title: Blood Purification
                Publisher: S. Karger AG
                ISSN (Print): 0253-5068
                ISSN (Electronic): 1421-9735
                Publication date Subscription-year: 2012
                Publication date (Print): March 2012
                Publication date (Electronic): 13 January 2012
                Volume: 33
                Issue: 1-3
                Pages: 88-100
                Affiliations
                aDepartment of Intensive Care, Austin Hospital, Heidelberg, Vic., Australia; bJohor Bahru Clinical School, Monash University Sunway Campus, Johor Bahru, Malaysia
                Author notes
                *Prof. Rinaldo Bellomo, Department of Intensive Care, Austin Hospital, Studley Road, Heidelberg, Melbourne, VIC 3084 (Australia), Tel. +61 3 9496 5992, E-Mail rinaldo.bellomo@austin.org.au
                Article
                Publisher ID: 333845 Other ID: Blood Purif 2012;33:88–100
                DOI: 10.1159/000333845
                PubMed ID: 22248671
                SO-VID: b9c0c969-78a8-4b52-9b73-2dd2595ea474
                Copyright © © 2012 S. Karger AG, Basel
                License:

                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.

                History
                Date received : 30 May 2011
                Date accepted : 28 September 2011
                Page count
                Figures: 2, Tables: 6, Pages: 13
                Categories
                Subject: Original Paper

                ScienceOpen disciplines: Cardiovascular Medicine,Nephrology
                Keywords: Cytokines,Hemofiltration,Plasmapheresis,Plasma exchange,High cut-off filters,Couples plasma filtration adsorption,Continuous renal replacement therapy
                Data availability:
                ScienceOpen disciplines: Cardiovascular Medicine, Nephrology
                Keywords: Cytokines, Hemofiltration, Plasmapheresis, Plasma exchange, High cut-off filters, Couples plasma filtration adsorption, Continuous renal replacement therapy

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