The effect of rheopheresis treatment on the cytokine profile in diabetic foot syndrome with hyperviscosity in the aspect of clinical changes: A preliminary study

Abstract

BACKGROUND: Rheopheresis is a selective extracorporal double cascade filtration treatment, which can extract high molecular weight proteins being responsible for hyperviscosity. As the whole blood and plasma viscosity decrease microcirculation improves. OBJECTIVE: In this preliminary study we aimed to analyze additional beneficial effects of rheopheresis treatment with changes of pro-inflammantory cytokine levels in diabetic foot syndrome patients. METHODS: Two rheopheresis treatments were performed for 6 patients with diabetic foot ulcer and/or neuropathy on consecutive days. Before and after the treatments whole blood and plasma viscosity, as well as IL-6, IL-8, and TNF-alpha serum levels were determined, and complex angiological and ENG examinations were performed. RESULTS: Rheopheresis decreased the whole blood and plasma viscosity, and the serum levels of IL-6, IL-8, and TNF-alpha were markedly reduced. The life quality of the patients improved, the ulcers healed, the pain decreased. Daily dose of analgesics decreased in the follow-up period (6 months). The ENG showed improving amplitude and/or normalizing conduction speed. CONCLUSION: Application of rheopheresis in patients with diabetic foot syndrome has a beneficial effect, providing favorable rheological condition, normalizing cytokine profile and reducing the sensorineural symptoms.

Monitoring and recovery of hyperglycaemia-induced endothelial dysfunction with rheopheresis in diabetic lower extremity ulceration with hyperviscosity

“…In our previous publication, we demonstrated in 6 patients that 2 consecutive rheopheresis treatments could significantly reduce the plasma concentrations of these inflammatory parameters. 8 Diabetes mellitus also has a significant prothrombotic effect, so we extended our studies to a marker describing the prothrombotic state. 32 Endothelin-1 plasma concentrations showed a slight decrease in all patients.…”

“…The results of our previous studies in 6 patients showed that IL-6 levels decreased by an average of 38.69%, IL-8 levels by 61.76%, and TNF-alpha plasma concentrations by 78.56% after two rheopheresis treatments. 8 Due to the novelty of rheopheresis, there is very little literature information available on treatment. Therefore, our further studies aimed to identify and explore the biochemical processes through which rheopheresis treatment can improve endothelial status by filtering inflammatory cytokines and viscosity-enhancing macromolecules, thus facilitating the treatment of complications associated with diabetic foot syndrome.…”