Premium
Vascular Endothelial Growth Factor and Soluble fms ‐like Tyrosine Kinase‐1 in Septic Shock Patients Treated With Direct Hemoperfusion With a Polymyxin B‐immobilized Fiber Column
Author(s) -
Ebihara Itaru,
Hirayama Kouichi,
Kaneko Shuzo,
Nagai Miho,
Ogawa Yujiro,
Fujita Shogo,
Usui Joichi,
Mase Kaori,
Yamagata Kunihiro,
Kobayashi Masaki
Publication year - 2008
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/j.1744-9987.2008.00589.x
Subject(s) - hemoperfusion , septic shock , medicine , vascular endothelial growth factor , sepsis , vascular permeability , polymyxin b , soluble fms like tyrosine kinase 1 , immunology , endocrinology , gastroenterology , pharmacology , vegf receptors , microbiology and biotechnology , placental growth factor , biology , hemodialysis , antibiotics
Sepsis is characterized by a systemic inflammatory response to a microbial pathogen. In sepsis, capillary permeability is a tightly regulated feature of microcirculation in all organ beds and is fundamentally altered. We investigated the vascular endothelial growth factor (VEGF) level as a vascular permeability factor and the soluble fms ‐like tyrosine kinase‐1 (Flt‐1) level as an antagonist of the VEGF receptors. Serum VEGF and soluble Flt‐1 levels in 21 patients with septic shock, who were treated with direct hemoperfusion with a polymyxin B‐immobilized fiber column (DHP‐PMX), were measured by enzyme‐linked immunoassay. The VEGF and the soluble Flt‐1 levels were more elevated in patients with septic shock than in controls. Between 14 survivors and 7 non‐survivors, there was no significant difference in VEGF level before the DHP‐PMX therapy, but the soluble Flt‐1 level of survivors was significantly lower than that of non‐survivors. Although there was no significant difference between starting and ending VEGF levels in survivors, in non‐survivors the VEGF level at the end of DHP‐PMX therapy was significantly lower than that at the start. In survivors, the soluble Flt‐1 level at the end of DHP‐PMX therapy was significantly lower than that at the start. On the other hand, in non‐survivors, there was no significant difference between the ending and starting soluble Flt‐1 levels. The soluble Flt‐1 level may be a suitable marker of disease severity and mortality.