title: Effect of polymyxin B-immobilized fiber hemoperfusion on serum high mobility group box-1 protein levels and oxidative stress in patients with acute respiratory distress syndrome.
abstract: Acute respiratory distress syndrome (ARDS) is characterized by diffuse inflammation in the lung and resultant permeability edema. Polymyxin B-immobilized fiber (PMX-F) hemoperfusion is effective for sepsis-induced ARDS. High mobility group box-1 protein (HMGB1) is newly recognized as a proinflammatory cytokine. The aim of the study was to determine whether blood HMGB1 levels are increased in patients with ARDS and whether PMX-F treatment affects these levels. Subjects were 20 sepsis-induced patients with ARDS treated by PMX-F column and 20 age-matched healthy volunteers. Polymyxin B-immobilized fiber treatment was carried out twice at a rate of 100 ml/min for 2 hours. Systolic and diastolic blood pressures, the PaO2/FiO2 (PF) ratio and endotoxin, HMGB1, and urinary 8-hydroxy-2'-deoxyguanosine (OHdG) levels were measured before and after PMX-F treatment. Blood endotoxin levels, blood HMGB1 levels, and urinary 8-OHdG levels were significantly higher in patients with ARDS than in healthy volunteers. Systolic and diastolic blood pressures and the PF ratio increased significantly after PMX-F treatments. Polymyxin B-immobilized fiber treatment reduced blood endotoxin, blood HMGB1, and urinary 8-OHdG levels significantly. These data suggest that HMGB1 and oxidative stress play a role in the pathogenesis of ARDS and that PMX-F treatment may ameliorate increased blood HMGB1 and urinary 8-OHdG levels in patients with ARDS.
authors.affiliation: Department of Medicine, Shinmatsudo Central General Hospital, Chiba, Japan.
authors.forename: Tsukasa
authors.initials: T
authors.lastname: Nakamura
authors.forename: Nobuharu
authors.initials: N
authors.lastname: Fujiwara
authors.forename: Eiichi
authors.initials: E
authors.lastname: Sato
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Kawagoe
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ueda
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamada
authors.forename: Hikaru
authors.initials: H
authors.lastname: Koide
mesh_terms: D000080242:8-Hydroxy-2'-Deoxyguanosine; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001794:Blood Pressure; D003849:Deoxyguanosine / Q000031:analogs & derivatives / Q000378:metabolism / Q000652:urine; D004487:Edema / Q000517:prevention & control; D004731:Endotoxins / Q000378:metabolism; D005260:Female; D024243:HMGB1 Protein / Q000378:metabolism*; D006464:Hemoperfusion; D006801:Humans; D008297:Male; D008875:Middle Aged; D018384:Oxidative Stress; D011112:Polymyxin B / Q000494:pharmacology*; D012128:Respiratory Distress Syndrome / Q000097:blood* / Q000628:therapy; D018805:Sepsis
chemical_list: D000900:Anti-Bacterial Agents; D004731:Endotoxins; D024243:HMGB1 Protein; D000080242:8-Hydroxy-2'-Deoxyguanosine; D003849:Deoxyguanosine; D011112:Polymyxin B