Cytokine Kinetics (TNF-a, IL-1�, IL-6) during Continuous Hemofiltration: A Laboratory and Clinical Study

Bommel, E. F. H. van; Hesse, Christina; Jutte, N. H. P. M.; Zietse, Robert; Bruining, H. A.; Weimar, Willem

doi:10.1159/000424615

Cited by 55 publications

(35 citation statements)

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“…Despite low clearances in the present study an appreciable reduction in IL-6 and IL-8 was achieved (130% reduction) due to the relatively high filtration rate of 1,800 ml/h on the small test solution volume of approximately 1 liter. Our findings are in accordance with previous in vitro studies that also found remarkable adsorption of TNF-·, most pronounced with the AN69 membrane [5,14]. However, in these studies, sieving of TNF-· appeared less than 30 min after the membrane was saturated and this was not the case in our study.…”

Section: Discussionsupporting

confidence: 93%

“…However, in these studies, sieving of TNF-· appeared less than 30 min after the membrane was saturated and this was not the case in our study. These differences are probably the result of the use of monomeric recombinant TNF-· (17 kD) in the studies of van Bommel et al [5] and Goldfarb and Golper [14], and the use of human (trimeric) TNF-· in our study. The same was true for IL-6.…”

Section: Discussionmentioning

confidence: 75%

“…Additional beneficial effects of continuous HF have been ascribed to clearance of toxic mediators [2][3][4]. Tumor necrosis factor-· (TNF-·) and interleukin-6 (IL-6) were found in the ultrafiltrate of septic shock patients in several studies, although the reported cytokine clearances varied enormously in these studies [5][6][7][8][9]. Differences in cytokine clearances can partly be explained by different HF techniques, ultrafiltration rates, hemofilters and cytokine assays.…”

Section: Introductionmentioning

confidence: 99%

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Cytokine Filtration and Adsorption during Pre- and Postdilution Hemofiltration in Four Different Membranes

1998

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In the present in vitro study we investigated filtration and adsorption of tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and interleukin-8 (IL-8) during predilution and postdilution hemofiltration with polysulfone, polyacrylonitrile, polyamide and cellulose triacetate membranes. The median sieving coefficient (SC) for all membranes was 0.0 for TNF-α, below 0.15 for IL-6 and below 0.15 for IL-8 during postdilution hemofiltration. Differences in SC between filtration modes were less than 0.05. Maximal differences in SC between membranes were 0.11 for IL-6, 0.0 for TNF-α, and 0.11 for IL-8. The progressive decrease in cytokine concentrations was identical between the two filtration modes and most pronounced with the polyacrylonitrile membrane (reduction 77% for IL-6, 39% for TNF-α and 95% for IL-8 after 4 h of hemofiltration). The relative contribution of adsorption to the reduction in cytokines was 100% for TNF-α for all membranes, between 53 (cellulose triacetate) and 83% (polyacrylonitrile) for IL-6, and for IL-8 between 0 (polysulfone) and 100% (polyacrylonitrile). In conclusion, the reduction in TNF-α, IL-6 and IL-8 was most impressive with the polyacrylonitrile membrane after 4 h of hemofiltration and was largely due to adsorption. Adsorption of TNF-α, IL-6 and IL-8 was also seen with the other membranes. None of the membranes filtered TNF-α. Sieving of IL-6 and IL-8 was low for all membranes with only marginal differences between membranes or between filtration modes.

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Section: Discussionsupporting

confidence: 93%

Section: Discussionmentioning

confidence: 75%

Section: Introductionmentioning

confidence: 99%

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Cytokine Filtration and Adsorption during Pre- and Postdilution Hemofiltration in Four Different Membranes

1998

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“…Standard or high cut-off techniques included continuous hemofiltration, 13,[15][16][17][18]20,22,23,35,[39][40][41]43,49,51 continuous hemodialysis 15,18,27,45 and continuous hemodiafiltration. 21,[24][25][26]36 The main cytokines measured in the clinical studies were interleukin-1b (IL-1b), interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), tumor necrosis factor-alpha (TNF-alpha) and interleukin-1 receptor antagonist (IL-1Ra) Other cytokines measured were interleukin-2 (IL-2), interleukin-2 receptor (IL-2R), interleukin-6 receptor (IL-6R) and soluble TNF-alpha receptors I and II (sTNFaRI and sTNFaRII). One paper 52 studied many other cytokines and details are included in the footnote of Table 1.…”

Section: Resultsmentioning

confidence: 99%

Techniques of extracorporeal cytokine removal: a systematic review of human studies

2013

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Background and aims: Hypercytokinemia is believed to be harmful and reducing cytokine levels is considered beneficial. Extracorporeal blood purification (EBP) techniques have been studied for the purpose of cytokine reduction. We aimed to study the efficacy of various EBP techniques for cytokine removal as defined by technical measures. Method: We conducted a systematic search for human clinical trials which focused on technical measures of cytokine removal by EBP techniques. We identified 41 articles and analyzed cytokine removal according to clearance (CL), sieving coefficient (SC), ultrafiltrate (UF) concentration and percentage removed. Results: We identified the following techniques for cytokine removal: standard hemofiltration, high volume hemofiltration (HVHF), high cut-off (HCO) hemofiltration, plasma filtration techniques, and adsorption techniques, ultrafiltration (UF) techniques relating to cardiopulmonary bypass (CPB), extracorporeal liver support systems and hybrid techniques including combined plasma filtration adsorption. Standard filtration techniques and UF techniques during CPB were generally poor at removing cytokines (median CL for interleukin 6 [IL-6]: 1.09 mL/min, TNF-alpha 0.74 mL/min). High cut-off techniques consistently offered moderate cytokine removal (median CL for IL-6: 26.5 mL/min, interleukin 1 receptor antagonist [IL-1RA]: 40.2 mL/ min). Plasma filtration and extracorporeal liver support appear promising but data are few. Only one paper studied combined plasma filtration and adsorption and found low rates of removal. The clinical significance of the cytokine removal achieved with more efficacious techniques is unknown. Conclusion: Human clinical trials indicate that high cut-off hemofiltration techniques, and perhaps plasma filtration and extracorporeal liver support techniques are likely more efficient in removing cytokines than standard techniques.

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“…[27] It is heartening that plasma TNF-α was reduced after six months of HDF patients, indicating a reduction of TNF-α-related vascular inflammation. Although previous research has indicated that TNF-α could not be filtrated due to trimer formation in plasma, [28] recent study had shown that it can be removed in high volume CRRT. [29] We believe that TNF-α can also be removed by convection in HDF.…”

Section: Discussionmentioning

confidence: 95%

Reduction of Pro-Inflammatory Cytokines through Hemodiafiltration

et al. 2008

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Cytokine Kinetics (TNF-a, IL-1�, IL-6) during Continuous Hemofiltration: A Laboratory and Clinical Study

Cited by 55 publications

References 0 publications

Cytokine Filtration and Adsorption during Pre- and Postdilution Hemofiltration in Four Different Membranes

Cytokine Filtration and Adsorption during Pre- and Postdilution Hemofiltration in Four Different Membranes

Techniques of extracorporeal cytokine removal: a systematic review of human studies

Reduction of Pro-Inflammatory Cytokines through Hemodiafiltration

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