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Novel Blood Purification System for Regulating Excessive Immune Reactions in Severe Sepsis and Septic Shock: An Ex Vivo Pilot Study
Author(s) -
Hara Yoshitaka,
Shimomura Yasuyo,
Nakamura Tomoyuki,
Kuriyama Naohide,
Yamashita Chizuru,
Kato Yu,
Miyasho Taku,
Sakai Toshikazu,
Yamada Shingo,
Moriyama Kazuhiro,
Nishida Osamu
Publication year - 2015
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/1744-9987.12338
Subject(s) - medicine , septic shock , sepsis , cytokine , immune system , ex vivo , immunology , granulocyte , adjuvant , in vivo , biology , microbiology and biotechnology
Promising results have been reported with blood purification as adjuvant treatment; however, the immunological mechanisms remain unclear. We have been developing a new blood purification system for regulating excessive immune reactions in severe sepsis and septic shock using a granulocyte adsorbing column ( A dacolumn [ A da]), and a cytokine‐adsorbing hemofilter ( AN 69 ST hemofilter [ AN 69]). Fresh porcine blood was circulated for 6 h in five experimental groups including A da and AN 69 to assess the effects of leukocyte adsorption, phagocytic activity and adhesiveness of granulocytes. In the present study, we found that A da mainly adsorbed granulocytes and monocytes, but not lymphocytes. The phagocytic activity level of granulocytes decreased, and adhesiveness increased, but the number of CD 11b‐positive cells markedly decreased in the current system. Elevated cytokine levels ( IL ‐1β, IL ‐8 and IL ‐10) at the outlet of A da were significantly lower than at the outlet of AN 69 due to cytokine adsorption. Further studies are needed to better understand cellular interactions.