Septic Shock Secondary to β-hemolytic Streptococcus-induced Necrotizing Fasciitis treated with a Novel Cytokine Adsorption Therapy

Hetz, Hubert; Berger, Reinhard; Recknagel, Peter; Steltzer, H.

doi:10.5301/ijao.5000315

Cited by 64 publications

(64 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Experimental and clinical studies have widely demonstrated their ability to modulate inflammatory mediators in septic shock [14][15][16]; preliminary case reports in systemic inflammatory response and septic shock [12,13], as well as recent experiences [17][18][19], have shown that the sorbent also reduces bilirubin and bile acids. This combined action may be helpful in supporting liver dysfunctions.…”

Section: Introductionmentioning

confidence: 99%

Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Gemelli

Cuoghi

Magnani³

et al. 2018

Blood Purif

View full text Add to dashboard Cite

Background/Aims: Many potentially toxic molecules accumulate in the blood during hepatic dysfunction. In clinical practice, it is very difficult to remove bilirubin, the most widely studied toxin, and particularly the unconjugated form, strongly albumin-bound. The aim of this in vitro study was to assess irreversible bilirubin adsorption as a protein-bound compound marker, using Cytosorb® (Cytosorbents Corp.), a new hemoadsorption device designed to remove cytokines. Methods: We performed 4 in vitro experiments, dynamic and static, with different albumin-bilirubin solutions. Results: All experiments showed the resin’s ability to break the albumin-bilirubin complex (Experiment 1, 2), leading to efficient bilirubin removal for 24 h (Removal Rate: 90% Experiment 3) with minimal albumin loss. No sign of bilirubin release from the charged resin was detected (Experiment 4). Conclusion: Cytosorb® seems a promising artificial liver support, thanks to its ability to adsorb bilirubin and its proven ability to modulate the cytokines involved in hepatic dysfunction.

show abstract

Section: Introductionmentioning

confidence: 99%

Removal of Bilirubin with a New Adsorbent System: In Vitro Kinetics

Gemelli

Cuoghi

Magnani³

et al. 2018

Blood Purif

View full text Add to dashboard Cite

show abstract

“…In clinical practice, sorbents have been used to eliminate industrial, pharmacological, or endogenous toxins such as bilirubin or porphyrines [11, 12]. Several new sorbents specifically designed for particular diseases and target molecules to be removed have been proposed in the last years and applied in clinical trials [13-18]. …”

Section: Introductionmentioning

confidence: 99%

Biocompatibility and Cytotoxic Evaluation of New Sorbent Cartridges for Blood Hemoperfusion

et al. 2018

View full text Add to dashboard Cite

Background/Aims: The use of adsorption cartridges for hemoperfusion (HP) is rapidly evolving. For these devices, the potential induced cytotoxicity is an important issue. The aim of this study was to investigate potential in vitro cytotoxic effects of different sorbent cartridges, HA130, HA230, HA330, HA380 (Jafron, China), on U937 monocytes. Methods: Monocytes were exposed to the sorbent material in static and dynamic manners. In static test, cell medium samples were collected after 24 h of incubation in the cartridges. In dynamic test, HP modality has been carried out and samples at 30, 60, 90, and 120 min were collected. Results: Compared to control samples, there was no evidence of increased necrosis or apoptosis in monocytes exposed to the cartridges both in the static and dynamic tests. Conclusion: Our in vitro testing suggests that HA cartridges carry an optimal level of biocompatibility and their use in HP is not associated with adverse reactions or signs of cytotoxicity.

show abstract

“…These devices either remove target molecules below a specific size, such as inflammatory cytokines [28], or are coated with ligands that bind and remove a specific type of PAMP, such as the use of Polymyxin B immobilized on hemofilters to remove endotoxin [20,29]. We recently reported the development of a microfluidic, dialysis-like therapeutic device for sepsis therapy or 'biospleen' that removes living pathogens and endotoxin from blood using magnetic nanoparticles coated with a genetically engineered form of the human opsonin, Mannose Binding Lectin, that lacks its complement fixation and coagulation domains, and is linked to an antibody Fc domain (FcMBL) [30].…”

Section: Introductionmentioning

confidence: 99%