title: Novel Blood Purification System for Regulating Excessive Immune Reactions in Severe Sepsis and Septic Shock: An Ex Vivo Pilot Study.
abstract: Promising results have been reported with blood purification as adjuvant treatment; however, the immunological mechanisms remain unclear. We have been developing a new blood purification system for regulating excessive immune reactions in severe sepsis and septic shock using a granulocyte adsorbing column (Adacolumn [Ada]), and a cytokine-adsorbing hemofilter (AN69ST hemofilter [AN69]). Fresh porcine blood was circulated for 6 h in five experimental groups including Ada and AN69 to assess the effects of leukocyte adsorption, phagocytic activity and adhesiveness of granulocytes. In the present study, we found that Ada mainly adsorbed granulocytes and monocytes, but not lymphocytes. The phagocytic activity level of granulocytes decreased, and adhesiveness increased, but the number of CD11b-positive cells markedly decreased in the current system. Elevated cytokine levels (IL-1β, IL-8 and IL-10) at the outlet of Ada were significantly lower than at the outlet of AN69 due to cytokine adsorption. Further studies are needed to better understand cellular interactions.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Hara
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Yasuyo
authors.initials: Y
authors.lastname: Shimomura
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Nakamura
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Naohide
authors.initials: N
authors.lastname: Kuriyama
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Chizuru
authors.initials: C
authors.lastname: Yamashita
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Yu
authors.initials: Y
authors.lastname: Kato
authors.affiliation: Department of Veterinary Science school of Veterinary Medicine, Rakuno Gakuen University School of Veterinary Medicine, Ebetsu, Hokkaido, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Miyasho
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Toshikazu
authors.initials: T
authors.lastname: Sakai
authors.affiliation: Department of Research and Development, Shino-Test Corporation, Sagamihara-shi, Kanagawa, Japan.
authors.forename: Shingo
authors.initials: S
authors.lastname: Yamada
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Moriyama
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Fujita Health University School of Medicine, Toyoake, Aichi, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Nishida
mesh_terms: D000327:Adsorption; D000818:Animals; D004195:Disease Models, Animal; D017583:Hemodiafiltration / Q000295:instrumentation / Q000379:methods; D007111:Immunity, Cellular / Q000502:physiology*; D016753:Interleukin-10 / Q000097:blood; D016209:Interleukin-8 / Q000097:blood; D007958:Leukocyte Count; D010865:Pilot Projects; D018805:Sepsis / Q000097:blood / Q000276:immunology / Q000628:therapy; D012772:Shock, Septic / Q000097:blood / Q000276:immunology / Q000628:therapy; D013552:Swine
chemical_list: C508609:IL10 protein, human; D016209:Interleukin-8; D016753:Interleukin-10
keywords: Blood purification; Cytokine; Granulocyte; Immunomodulation; Sepsis