Effect of hemoperfusion with polymyxin B-immobilized fiber on plasma endothelin-1 and endothelin-1 mRNA in monocytes from patients with sepsis.
Hemoperfusion using polymyxin B-immobilized fiber (PMX-F) is reported to be an effective treatment for sepsis. The aim of the present study is to assess whether plasma endothelin-1 (ET-1) and ET-1 messenger RNA (mRNA) levels in peripheral-blood monocytes are altered in patients with sepsis and whether PMX-F treatment affects plasma ET-1 and monocyte ET-1 mRNA levels. Sixteen patients with sepsis and 20 healthy volunteers were included in this study. Plasma ET-1 concentration was measured by radioimmunoassay (RIA), and plasma levels of transforming growth factor-beta (TGF-beta), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1beta (IL-1beta) were measured by enzyme-linked immunosorbent assay (ELISA). Sixteen patients with sepsis were treated with direct hemoperfusion using PMX-F columns. Blood endotoxin levels decreased significantly from 35 to 10 pg/mL after two treatments of direct hemoperfusion, each for 2 hours. Patients with sepsis showed significantly increased levels of plasma ET-1 (P < 0.001) and monocyte ET-1 mRNA (P < 0.001) compared with healthy volunteers. However, no differences in plasma levels of TGF-beta, TNF-alpha, and IL-1beta existed between patients with sepsis and healthy volunteers. Increased plasma ET-1 levels and monocyte ET-1 mRNA levels in patients with sepsis decreased significantly after PMX-F treatment (P < 0.01). These data suggest that the secretion of ET-1 from peripheral-blood monocytes may be stimulated by endotoxin, and PMX-F treatment may be effective in reducing ET-1 secretion in patients with sepsis.
Ebihara
I
I
Department of Medicine, Koto Hospital, Tokyo, Japan.
Nakamura
T
T
Shimada
N
N
Shoji
H
H
Koide
H
H
D018806:APACHE; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D019332:Endothelin-1 / Q000097:blood* / Q000187:drug effects; D019446:Endotoxemia / Q000097:blood / Q000628:therapy; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000097:blood / Q000628:therapy; D016908:Gram-Positive Bacterial Infections / Q000097:blood / Q000628:therapy; D006464:Hemoperfusion / Q000379:methods* / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000737:chemistry* / Q000187:drug effects; D011112:Polymyxin B / Q000627:therapeutic use*; D012333:RNA, Messenger / Q000097:blood* / Q000187:drug effects; D018805:Sepsis / Q000097:blood / Q000628:therapy*; D018709:Statistics, Nonparametric
D000900:Anti-Bacterial Agents; D019332:Endothelin-1; D012333:RNA, Messenger; D011112:Polymyxin B