title: Angiopoietin balance in septic shock patients with acute lung injury: effect of direct hemoperfusion with polymyxin B-immobilized fiber.
abstract: Acute lung injury (ALI) in sepsis is characterized by an increase in microvascular permeability, resulting in pulmonary edema. Several studies have suggested that angiopoietin-1 and -2 play a contributory role in the pathogenesis of ALI. Polymyxin B-immobilized fiber column hemoperfusion is effective for sepsis-induced ALI. We investigated the angiopoietin levels before and after direct hemoperfusion with polymyxin B-immobilized fiber column (PMX) therapy. Enzyme-linked immunoassay was used to measure the serum angiopoietin-1 and -2 levels in 25 patients with septic shock treated with PMX. Eleven of the 25 patients were diagnosed with ALI. There was a significant positive correlation between the angiopoietin-1 level and the PaO(2) /FiO(2) ratio, but there was a significant inverse correlation between the angiopoietin-2 level and the PaO(2) /FiO(2) ratio. The mean angiopoietin-1 level before PMX therapy in the ALI group was significantly lower and the mean angiopoietin-2 level was significantly higher than in the non-ALI group. The mean angiopoietin-1 level of the ALI patients in response to PMX therapy was increased during PMX therapy, but that of the non-ALI patients with newly occurring ALI showed a decreased angiopoietin-1 level. On the other hand, the mean angiopoietin-2 level of the responders was decreased during PMX therapy, but that of patients with newly occurring ALI showed an increased angiopoietin-2 level. This result suggested that each angiopoietin-1 and -2 level may play a role in the pathogenesis of ALI and that PMX therapy ameliorates the angiopoietin balance in patients with ALI in sepsis.
authors: Department of Nephrology, Mito Saiseikai General Hospital, Mito, Japan. itaruebi@yahoo.co.jp
authors: Itaru
authors: I
authors: Ebihara
authors: Kouichi
authors: K
authors: Hirayama
authors: Miho
authors: M
authors: Nagai
authors: Tomoko
authors: T
authors: Kakita
authors: Kentaro
authors: K
authors: Sakai
authors: Reiko
authors: R
authors: Tajima
authors: Chihiro
authors: C
authors: Sato
authors: Hiromi
authors: H
authors: Kurosawa
authors: Amane
authors: A
authors: Togashi
authors: Akiko
authors: A
authors: Okada
authors: Joichi
authors: J
authors: Usui
authors: Kunihiro
authors: K
authors: Yamagata
authors: Masaki
authors: M
authors: Kobayashi
mesh_terms: D055371:Acute Lung Injury / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D000368:Aged; D000369:Aged, 80 and over; D042683:Angiopoietin-1 / Q000097:blood*; D042702:Angiopoietin-2 / Q000097:blood*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011112:Polymyxin B / Q000737:chemistry; D012772:Shock, Septic / Q000150:complications / Q000503:physiopathology / Q000628:therapy*
chemical_list: D042683:Angiopoietin-1; D042702:Angiopoietin-2; D011112:Polymyxin B