Hemoperfusion With an Immobilized Polymyxin B Fiber Column Reduces Circulating Interleukin‐8 Concentrations

Abstract

In the present study, we examined whether the performance of hemoperfusion with an immobilized polymyxin B fiber column (DHP-PMX) reduces circulating interleukin-8 concentration in patients with sepsis. Fifteen patients with sepsis satisfying the following criteria were enrolled in the study: (i) signs of systemic inflammatory response syndrome caused by infection; and (ii) mean arterial blood pressure > or =60 mm Hg (irrespective of the use of catecholamines). A thermodilution catheter was inserted prior to DHP-PMX for appropriate intravenous infusion, and the DHP-PMX was carried out twice at 24 h intervals (for 3 h each time). Circulating interleukin-8 concentration was measured seven times. The sequential organ failure assessment (SOFA) score was calculated twice. Circulating interleukin-8 concentration was 55 +/- 15.7 pg/mL before DHP-PMX, while it was 101 +/- 58.8 pg/mL immediately after the first session of treatment. It was 24 +/- 9.0 pg/mL before the second session of DHP-PMX, and it was 28 +/- 8.0 pg/mL immediately after the second session. The IL-8 level was 17 +/- 4.3 pg/mL at 48 h afterward, and 18 +/- 4.3 pg/mL at 72 h afterward, showing a significant decrease from 48 h onwards, compared with before treatment (P < 0.05). The SOFA score was 9 +/- 1.5 and the APACHE II score was 19 +/- 2.0 before DHP-PMX, while the SOFA score was 7.0 +/- 0.9 at 72 h afterward, showing a significant decrease compared with before treatment (P < 0.05). The present findings indicate that DHP-PMX indirectly reduces circulating interleukin-8 concentration and improves SOFA score.

Hemoperfusion With an Immobilized Polymyxin B Fiber Column Decreases Macrophage and Monocyte Activity

“…One of the causes of the various clinical effects (11–15) we have reported seems to be the inhibition of monocyte/macrophage activation by DHP‐PMX. Inhibition of monocyte/macrophage activation results in the inhibition of the production of various pro‐inflammatory cytokines and inducible nitric oxide, which are discharged from immunocompetent cells.…”

Clinical effects of polymyxin B‐immobilized fiber column direct hemoperfusion for severe bacterial meningitis: A series of 10 cases

“…When this inflammation spreads to the brain parenchyma and cerebral blood vessels, it causes cerebral edema, increased intracranial pressure, cerebrovascular disability, cerebral vasculitis, and neuronal damage, which leads to poor outcomes such as neurological sequelae and death . PMX‐DHP may suppress inflammation by absorbing activated leukocytes and LTA and reducing pro‐inflammatory cytokines . Eight of our 10 patients were identified to have Gram‐positive bacteria, which do not have lipopolysaccharide.…”

The Clinical Significance of Serum Procalcitonin Levels following Direct Hemoperfusion with Polymyxin B-Immobilized Fiber Column in Septic Patients with Colorectal Perforation

“…Toraymyxin has been used clinically in Japan since 1994 and has been shown to improve survival [30] and hemodynamic parameters in clinical trials. Several authors have reported that PMX treatment reduces circulating inflammatory mediators in septic shock patients [26,31,32] . In a recent review article, PMX was also described as having some positive effects on blood pressure, use of vasoactive agents, gas exchange and mortality [14] .…”