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Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock

Endotoxin adsorption therapy by polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) has been used for the treatment of septic shock patients. Endotoxin, an outer membrane component of Gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin trigg...

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Autores principales: Mitaka, Chieko, Kusaoi, Makio, Kawagoe, Izumi, Satoh, Daizoh
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Korean Society of Critical Care Medicine 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182162/
https://www.ncbi.nlm.nih.gov/pubmed/33813808
http://dx.doi.org/10.4266/acc.2021.00150
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author Mitaka, Chieko
Kusaoi, Makio
Kawagoe, Izumi
Satoh, Daizoh
author_facet Mitaka, Chieko
Kusaoi, Makio
Kawagoe, Izumi
Satoh, Daizoh
author_sort Mitaka, Chieko
collection PubMed
description Endotoxin adsorption therapy by polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) has been used for the treatment of septic shock patients. Endotoxin, an outer membrane component of Gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin triggers a signaling cascade for leukocytes, macrophage, and endothelial cells to secrete various mediators including cytokines and nitric oxide, leading to septic shock and multiple organ dysfunction syndrome. PMX-DHP directly adsorbed not only endotoxin but also monocytes and anandamide. It reduced blood levels of inflammatory cytokines such as interleukin (IL)-1, IL-6, tumor necrosis factor-alpha and IL-17A, adhesion molecules, plasminogen activator inhibitor 1, and high mobility group box-1. As a result, PMX-DHP increased blood pressure and reduced the dose of vasoactive-inotropic agents. PMX-DHP improved monocyte human leukocyte antigen-DR expression in patients with severe sepsis and septic shock. A post hoc analysis of EUPHRATES (Evaluating the Use of Polymyxin B Hemoperfusion in Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock) trial has shown that PMX-DHP significantly reduced 28-day mortality compared with the control group in septic shock patients with endotoxin activity assay level between 0.60 and 0.89. Longer duration of PMX-DHP may be another strategy to bring out the beneficial effects of PMX-DHP. Further studies are needed to confirm the efficacy of PMX-DHP treatment for septic shock.
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spelling pubmed-81821622021-06-15 Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock Mitaka, Chieko Kusaoi, Makio Kawagoe, Izumi Satoh, Daizoh Acute Crit Care Review Article Endotoxin adsorption therapy by polymyxin B-immobilized fiber column direct hemoperfusion (PMX-DHP) has been used for the treatment of septic shock patients. Endotoxin, an outer membrane component of Gram-negative bacteria, plays an important role in the pathogenesis of septic shock. Endotoxin triggers a signaling cascade for leukocytes, macrophage, and endothelial cells to secrete various mediators including cytokines and nitric oxide, leading to septic shock and multiple organ dysfunction syndrome. PMX-DHP directly adsorbed not only endotoxin but also monocytes and anandamide. It reduced blood levels of inflammatory cytokines such as interleukin (IL)-1, IL-6, tumor necrosis factor-alpha and IL-17A, adhesion molecules, plasminogen activator inhibitor 1, and high mobility group box-1. As a result, PMX-DHP increased blood pressure and reduced the dose of vasoactive-inotropic agents. PMX-DHP improved monocyte human leukocyte antigen-DR expression in patients with severe sepsis and septic shock. A post hoc analysis of EUPHRATES (Evaluating the Use of Polymyxin B Hemoperfusion in Randomized Controlled Trial of Adults Treated for Endotoxemia and Septic Shock) trial has shown that PMX-DHP significantly reduced 28-day mortality compared with the control group in septic shock patients with endotoxin activity assay level between 0.60 and 0.89. Longer duration of PMX-DHP may be another strategy to bring out the beneficial effects of PMX-DHP. Further studies are needed to confirm the efficacy of PMX-DHP treatment for septic shock. Korean Society of Critical Care Medicine 2021-05 2021-04-04 /pmc/articles/PMC8182162/ /pubmed/33813808 http://dx.doi.org/10.4266/acc.2021.00150 Text en Copyright © 2021 The Korean Society of Critical Care Medicine https://creativecommons.org/licenses/by-nc/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Review Article
Mitaka, Chieko
Kusaoi, Makio
Kawagoe, Izumi
Satoh, Daizoh
Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title_full Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title_fullStr Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title_full_unstemmed Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title_short Up-to-date information on polymyxin B-immobilized fiber column direct hemoperfusion for septic shock
title_sort up-to-date information on polymyxin b-immobilized fiber column direct hemoperfusion for septic shock
topic Review Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8182162/
https://www.ncbi.nlm.nih.gov/pubmed/33813808
http://dx.doi.org/10.4266/acc.2021.00150
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