Treatment with polymyxin B-immobilized fiber reduces platelet activation in septic shock patients: decrease in plasma levels of soluble P-selectin, platelet factor 4 and beta-thromboglobulin.
OBJECTIVE
To clarify whether plasma concentrations of soluble P-selectin, platelet factor-4 (PF-4) and beta-thromboglobulin (betaTG) are altered in patients with septic shock and whether polymyxin B-immobilized fiber (PMX-F) treatment affects these changes.


METHODS
Thirty patients with septic shock who were treated with PMX-F (group A), 20 such patients who received conventional therapies (group B) and 20 healthy control subjects(group C).


METHODS
ELISA using commercial kits. Endotoxin elimination by direct hemoperfusion using PMX-F.


RESULTS
Blood endotoxin levels decreased significantly from 49.4+/-8.8 pg/ml to 13.0+/-4.5 pg/ml after PMX-F treatment. The pretreatment plasma concentrations of soluble P-selectin, PF-4 and betaTG in patients in groups A and B were significantly higher than those in group C (p<0.001). Plasma concentrations of these factors decreased significantly in group A after PMX-F treatment (p<0.01); however, the concentrations in group B were not altered after conventional treatment. The survival rate of group A (60%) was higher than that of group B (30%).


CONCLUSIONS
Our findings suggest that soluble P-selectin, PF-4 and betaTG may be associated with septic shock and that PMX-F is effective in reducing these markers in patients with septic shock.
Nakamura
T
T
Department of Medicine, Misato Junshin Hospital, Saitama, Japan.
Ebihara
I
I
Shoji
H
H
Ushiyama
C
C
Suzuki
S
S
Koide
H
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000097:blood* / Q000378:metabolism; D015539:Platelet Activation / Q000187:drug effects*; D010978:Platelet Factor 4 / Q000378:metabolism*; D011112:Polymyxin B / Q000627:therapeutic use*; D012772:Shock, Septic / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism / Q000382:microbiology; D001620:beta-Thromboglobulin / Q000378:metabolism*
D000900:Anti-Bacterial Agents; D019007:P-Selectin; D001620:beta-Thromboglobulin; D010978:Platelet Factor 4; D011112:Polymyxin B