Hemoperfusion With an Immobilized Polymyxin B Fiber Column Inhibits Activation of Vascular Endothelial Cells

Kushi, Hidehiko; Nakahara, Jun; Miki, Takahiro; Okamoto, Ken‐ichi; Saito, Takeshi; Tanjo, K

doi:10.1111/j.1744-9987.2005.00286.x

Cited by 27 publications

(23 citation statements)

References 18 publications

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“…The blood levels of some inflammatory chemokines, e.g. metalloproteinase 9, tissue inhibitor of metalloproteinase 1 [4], neutrophil elastase, IL-8 [46] and IL-18 [47], are immediately decreased in ARDS patients after PMX-DHP. Seo et al [18] have reported that IL-6, IL-8 and plasminogen activator inhibitor 1 are decreased in patients with rapidly progressive IP who responded to PMX-DHP.…”

Section: Discussionmentioning

confidence: 99%

Direct Hemoperfusion Using Immobilized Polymyxin B in Patients with Rapidly Progressive Interstitial Pneumonias: A Retrospective Study

et al. 2010

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Background: Rapidly progressive interstitial pneumonia (IP), including acute exacerbation of IP, has a high mortality rate. Direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) was recently identified as an effective treatment for sepsis-associated acute respiratory distress syndrome. However, little is known about the effectiveness of PMX-DHP for rapidly progressive IP. Objectives: The present study investigates whether PMX-DHP is safe and effective against rapidly progressive IP. Methods: We retrospectively examined the effects of PMX-DHP in 33 consecutive patients with rapidly progressive IP who were resistant to steroid pulse therapy. Patients were hospitalized at Nagasaki University Hospital between 2006 and 2009. Results: Seventy-two hours after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127–153 mm Hg) had significantly improved. One week after PMX-DHP, the arterial oxygen tension/inspiratory oxygen fraction ratio (median 127–227 mm Hg), the alveolar-arterial difference of oxygen (median 371–177 mm Hg) and the number of positive criteria for systemic inflammatory response syndrome had significantly improved, despite the ineffectiveness of corticosteroid pulse therapy. The serum level of monocyte chemotactic protein 1 was significantly decreased immediately after PMX-DHP. Conclusions: PMX-DHP was safe and effective in improving oxygenation and systemic inflammatory response syndromein patients with rapidly progressive IP. The beneficialeffects of PMX-DHP may be at least partially due to the inhibition of monocyte activation.

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Section: Discussionmentioning

confidence: 99%

Direct Hemoperfusion Using Immobilized Polymyxin B in Patients with Rapidly Progressive Interstitial Pneumonias: A Retrospective Study

et al. 2010

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“…Reduced levels of a number of other mediators have been reported after PMX. The list includes IL-6 [12,13,14], IL-10 [13,14], IL-18 [15], TNF-α [14,16], metalloproteinase-9 and tissue inhibitor of metalloproteinase-1 [7], plasminogen activator inhibitor-1 [14,16,17], neutrophil elastase [9,18], platelet factor-4 [15], β-thromboglobulin [15], soluble P selectin [15] and endogenous cannabinoids [15,19] such as anandamide. Several of these mediators cause lung injury, increase vascular permeability and worsen intrapulmonary shunting.…”

Section: Pmx In Acute Respiratory Failurementioning

confidence: 99%

New Trends in Polymyxin B Hemoperfusion: From 2006 to 2013

Cruz¹

2014

Blood Purif

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Endotoxin, one of the principal components on the outer membrane of Gram-negative bacteria, is considered a key and early component in the pathogenesis of sepsis. Polymyxin B bound to polystyrene fibers (PMX) is a medical device capable of removing circulating endotoxin by adsorption. The most comprehensive analysis to date of clinical experience with this device remains a meta-analysis of 28 studies between 1998 and 2006. This showed that PMX hemoperfusion was associated with improved blood pressure and a reduction in dopamine dose, improved PaO₂/FiO₂ ratio and lower mortality. Since this meta-analysis, over 50 additional studies on PMX have been published. The majority are observational, with small sample sizes. Notable among the newer studies is the increasing interest in the use of PMX therapy in interstitial pneumonias and idiopathic pulmonary fibrosis, as well as in longer treatment duration and earlier initiation of PMX therapy in an attempt to further improve clinical outcomes. These observational data highlight important aspects of PMX therapy worthy of more rigorous investigation in future studies.

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“…We have previously reported [11] that the PMX prevents the activation of vascular endothelial cells, but no studies have been performed to assess the effect of PMX on the circulating neutrophil elastase level. Therefore, we investigated the time course of the blood level of neutrophil elastase to determine whether PMX altered the circulating amount of this enzyme.…”

mentioning

confidence: 99%

Hemoperfusion with an Immobilized Polymyxin B Column Reduces the Blood Level of Neutrophil Elastase

Kushi

Miki²,

Nakahara³

et al. 2006

Blood Purif

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Background: We investigated whether direct hemoperfusion with an immobilized polymyxin B column (DHP with PMX) could reduce the blood level of neutrophil elastase. Methods: 20 sepsis patients were enrolled in the study. DHP with PMX was performed twice within a 24-hour period. Neutrophil elastase was measured 7 times. Results: Neutrophil elastase was 468 ± 75.1 µg/l, while it was 1,531 ± 201.7 µg/l immediately after the first session, declined to 351 ± 73.9 µg/l before the second session of DHP with PMX, and increased again to 599.3 ± 112.7 µg/l immediately after the second session, 328 ± 73.7 µg/l at 24 h, 264 ± 39.3 µg/l at 48 h, and 230 ± 36.1 µg/l at 72 h after DHP with PMX. The levels from 48 h onwards were significantly lower compared with that before treatment. Conclusion: DHP with PMX has an overall effect that reduces circulating neutrophil elastase levels.

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Hemoperfusion With an Immobilized Polymyxin B Fiber Column Inhibits Activation of Vascular Endothelial Cells

Cited by 27 publications

References 18 publications

Direct Hemoperfusion Using Immobilized Polymyxin B in Patients with Rapidly Progressive Interstitial Pneumonias: A Retrospective Study

Direct Hemoperfusion Using Immobilized Polymyxin B in Patients with Rapidly Progressive Interstitial Pneumonias: A Retrospective Study

New Trends in Polymyxin B Hemoperfusion: From 2006 to 2013

Hemoperfusion with an Immobilized Polymyxin B Column Reduces the Blood Level of Neutrophil Elastase

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