Effects of hemoperfusion with polymyxin B-immobilized fibre on serum neopterin and soluble interleukin-2 receptor concentrations in patients with septic shock.
OBJECTIVE
the aim of the present study was to determine whether serum neopterin and soluble interleukin (IL)-2 receptor levels were related to the development of septic shock and whether polymyxin B-immobilized fibre (PMX-F) treatment affects these levels.


METHODS
we examined 24 patients admitted to our intensive care unit with Gram-negative septic shock. Serum neopterin and soluble IL-2 receptor levels were measured using commercially available test kits. Patients were treated with direct hemoperfusion using PMX-F columns.


RESULTS
fifteen out of 24 patients (63%) survived and were discharged from our hospitals within 30 days after PMX-F treatment. Blood endotoxin levels decreased significantly from 49.2+/-8.6 pg/ml to 13.2+/-4.4 pg/ml after PMX-F treatment. The pretreatment serum concentrations of neopterin and IL-2 receptor were significantly higher in the nine non-surviving patients with septic shock than in the 15 surviving patients (P<0.01) and 20 control subjects (P<0.001). Serum concentrations of neopterin and IL-2 receptor in patients with septic shock decreased significantly after PMX-F treatment (P<0.01).


CONCLUSIONS
these data suggest that serum neopterin and IL-2 receptor concentrations may be prognostic indicators in patients with septic shock. PMX-F treatment may be effective for reducing serum neopterin and IL-2 receptor concentrations.
Nakamura
T
T
Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
Ebihara
I
I
Shimada
N
N
Suzuki
S
S
Ushiyama
C
C
Shoji
H
H
Koide
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001794:Blood Pressure; D001831:Body Temperature; D004731:Endotoxins / Q000097:blood; D005260:Female; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D008875:Middle Aged; D019798:Neopterin / Q000097:blood*; D011112:Polymyxin B / Q000627:therapeutic use*; D015375:Receptors, Interleukin-2 / Q000097:blood*; D012772:Shock, Septic / Q000097:blood / Q000628:therapy*; D012995:Solubility; D013599:Systole; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D004731:Endotoxins; D015375:Receptors, Interleukin-2; D019798:Neopterin; D011112:Polymyxin B