Improved treatment of systemic blood infections using antibiotics with extracorporeal opsonin hemoadsorption

Didar, Tohid F.; Cartwright, Mark; Rottman, Martin; Graveline, Amanda; Gamini, Nazita; Watters, Alexander L.; Leslie, Daniel C.; Mammoto, Tadanori; Rodas, Melissa; Kang, Joo H.; Waterhouse, Anna; Seiler, Benjamin T.; Lombardo, Patrick; Qendro, Elisabet I.; Super, Michael; Ingber, Donald E.

doi:10.1016/j.biomaterials.2015.07.046

Cited by 68 publications

(67 citation statements)

References 36 publications

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“…The first animal study evaluating this new device has shown promising results, in synergy with antibiotics. Didar et al [73] observed that treatment with bactericidal antibiotics in septic rats resulted in a major increase of PAMPs blood levels, but these PAMPs were actively removed from blood with the FcMBL-hemoadsorption device; clinically, they also observed more stable vital signs in the septic rats treated with antibiotics and FcMBL-hemoadsoprtion as compared to antibiotics alone.…”

Section: Patientsmentioning

confidence: 99%

Extracorporeal Blood Purification Therapies for Sepsis

2019

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Extracorporeal blood purification is proposed as an adjuvant therapy for sepsis, aiming at controlling the associated dysregulation of the immune system, which is known to induce organ dysfunctions. Different therapies have been developed to address certain steps of the immune dysregulation. Most of the available blood purification devices focus on a single target, such as the endotoxin that triggers the immune cascade, or the cytokine storm that causes organ damages. However, the highly adsorptive membrane named oXiris® is a unique 4-in-1 device that combines cytokine and endotoxin removal properties, renal replacement function, and antithrombogenic properties. More recently, promising treatments that focus on the pathogen itself or the immune cells have been developed and are currently under investigation. In this review, we aim to summarize, according to their target, the different extracorporeal blood purification techniques that are already available for use. We will also briefly introduce the most recent techniques that are still under development. Because of its unique ability to remove both endotoxins and cytokines, we will particularly discuss the highly adsorptive preheparinized oXiris® membrane. We will present its properties, advantages, pitfalls, as well as therapeutic perspectives based on experimental and clinical data. Video Journal Club “Cappuccino with Claudio Ronco” at https://www.karger.com/Journal/ArticleNews/223997?sponsor=52

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Section: Patientsmentioning

confidence: 99%

Extracorporeal Blood Purification Therapies for Sepsis

2019

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“…packed columns, chip-based sensors) [16,17]. Binding ligands include mannose binding lectin, [11,18,19] zinc dipicolylamine [13,20,21], lysozyme [14] and some biopolymers [16]. Many of these methods process microliter volumes of whole blood that often have been heavily diluted.…”

Section: Introductionmentioning

confidence: 99%

Rapid separation of bacteria from blood – Chemical aspects

Alizadeh

Wood

Buchanan

et al. 2017

Colloids and Surfaces B: Biointerfaces

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To rapidly diagnose infectious organisms causing blood sepsis, bacteria must be rapidly separated from blood, a very difficult process considering that concentrations of bacteria are many orders of magnitude lower than concentrations of blood cells. We have successfully separated bacteria from red and white blood cells using a sedimentation process in which the separation is driven by differences in density and size. Seven mL of whole human blood spiked with bacteria is placed in a 12-cm hollow disk and spun at 3000 rpm for 1 min. The red and white cells sediment more than 30-fold faster than bacteria, leaving much of the bacteria in the plasma. When the disk is slowly decelerated, the plasma flows to a collection site and the red and white cells are trapped in the disk. Analysis of the recovered plasma shows that about 36% of the bacteria is recovered in the plasma. The plasma is not perfectly clear of red blood cells, but about 94% have been removed. This paper describes the effects of various chemical aspects of this process, including the influence of anticoagulant chemistry on the separation efficiency and the use of wetting agents and platelet aggregators that may influence the bacterial recovery. In a clinical scenario, the recovered bacteria can be subsequently analyzed to determine their species and resistance to various antibiotics.

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“…Cytokine-absorbing hemofilters decreased circulating pro-inflammatory cytokines, heart rate, blood lactate level, intra-abdominal pressure and mortality rate in patients with severe acute pancreatitis [52]. Fibers coated with endotoxin-binding polymyxin B [53, 54], opsonin [55, 56] or PEI [57] have been shown to remove endotoxin and pathogens from patient’s blood and ameliorated sepsis and acute respiratory distress syndrome. However, no such hemofilters have been developed to remove DAMPs from the blood of patients with sterile inflammatory and thrombotic complications.…”

Section: Discussionmentioning

confidence: 99%

Nucleic acid scavenging microfiber mesh inhibits trauma-induced inflammation and thrombosis

et al. 2017

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Trauma patients produce a host of danger signals and high levels of damage-associated molecular patterns (DAMPs) after cellular injury and tissue damage. These DAMPs are directly and indirectly involved in the pathogenesis of various inflammatory and thrombotic complications in patients with severe injuries. No effective therapeutic agents for the removal of DAMPs from blood or tissue fluid have been developed. Herein, we demonstrated that nucleic acid binding polymers, e.g., polyethylenimine (PEI) and polyamidoamine dendrimers, immobilized onto electrospun microfiber mesh can effectively capture various DAMPs, such as extracellular DNAs and high mobility group box 1 (HMGB1). Furthermore, treatment with PEI-immobilized microfiber mesh abrogated the ability of DAMPs, released from dead and dying cells in culture or found in patients following traumatic injury, to activate innate immune responses and coagulation in vitro and in vivo. Nucleic acid scavenging microfiber meshes represent an effective strategy to combat inflammation and thrombosis in trauma.

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Improved treatment of systemic blood infections using antibiotics with extracorporeal opsonin hemoadsorption

Cited by 68 publications

References 36 publications

Extracorporeal Blood Purification Therapies for Sepsis

Extracorporeal Blood Purification Therapies for Sepsis

Rapid separation of bacteria from blood – Chemical aspects

Nucleic acid scavenging microfiber mesh inhibits trauma-induced inflammation and thrombosis

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