Can the Reduction of Cytokines Stop the Progression of Sepsis?

Abstract

In this study, we aimed to analyze the laboratory and clinical results of cytokine hemadsorption as an immunomodulation therapy in ICU patients diagnosed with sepsis or septic shock. MethodsThe levels of procalcitonin (PCT) and C-reactive protein (CRP), determined to be indicators of infection/sepsis, and the levels of interleukins (IL-6, IL-8, and IL-10) and tumor necrosis factor α (TNFα), deemed as indicators of the cytokine storm, were compared among 32 patients before and after the hemadsorption procedure. ResultsThe hemadsorption significantly reduced the levels of IL-6, IL-8, IL-10, TNFα, PCT, CRP, Acute Physiology and Chronic Health Evaluation (APACHE) scores, mortality rate, and Sequential Organ Failure Assessment (SOFA) scores (p<0.05). APACHE scores and the mean predicted mortality rate (PMR) of the non-survivors measured before the procedure was significantly higher than those of survivors (p=0.002 for both). IL-10, APACHE scores, and the mortality rates determined before the hemadsorption procedure were deemed significant parameters to predict the mortality among all ICU patients (p<0.05). IL-10 levels ≤125.3 ng/L, APACHE score >30, and PMR >70.33 were significantly associated with the mortality rates of all patients, indicating that these three parameters determined before the hemadsorption may be good predictors of mortality among ICU patients with sepsis. ConclusionThe progression of sepsis in ICU patients may be prevented with cytokine hemadsorption applied as an immunomodulator therapy.

The Clinical and Laboratory Efficacy of HA 330 Treatment Combined with Continuous Renal Replacement Therapy in Septic Shock Patients: A Case Series

“…Similarly, in a recent prospective study by Kacar et al [16], the use of HA 330 hemadsorption for 3 days in patients with septic shock was reported to be associated with reduction in inflammatory parameters including WBC, neutrophil counts, CRP, and procalcitonin levels. Another study found that there was relationship between HA 330 treatment and reduced SOFA, PCT, and CRP levels in critically ill patients [17]. Cytosorb [18][19][20], as well as HA 330 [9,21], is frequently used in removal of cytokines via hemoperfusion in patients with sepsis/septic shock.…”

“…Patients who received hemoperfusion treatment had statistically significant decreased serum IL-6 and IL-8 levels [9]. In a recent prospective study in 32 critically ill patients receiving HA 330 therapy by Koc et al [17], serum IL-6, IL-8, IL-10, and TNF-a levels were reported to significantly decrease with hemoadsorption treatment. Our findings revealed a nonstatistically significant slightly lower decrease in inflammatory cytokines in patients treated with HA 330 than reported in the abovementioned studies, which seems to be related to larger sample size of these studies as well as the higher mortality rate.…”