Nagaki M, Hughes R D, Keane H M, Lau J Y, Williams R
Institute of Liver Studies, King's College School of Medicine and Dentistry, London, United Kingdom.
Circ Shock. 1992 Nov;38(3):182-8.
In vitro plasma perfusion experiments were performed using small columns containing either resin or charcoal adsorbents to assess the removal of cytokines and endotoxin. 125I-labelled tumor necrosis factor-alpha (TNF-alpha; 500 pg/ml) and interleukin-6 (IL-6; 10 ng/ml) were added individually to human plasma. Over 4 hr of perfusion, Amberlite XAD-7 resin removed 32.5% +/- 3.3% (n = 5) of the initial amount of TNF-alpha and 71.4% +/- 3.8% (n = 5) of the initial amount of IL-6. DHP-1 polyhema-coated activated charcoal removed 17.2% +/- 6.2% (n = 5) of TNF-alpha and 48.5% +/- 7.4% (n = 5) of IL-6. Preliminary experiments were performed with lipopolysaccharide (LPS; 100 ng/ml) and interleukin-1 alpha (IL-1 alpha; 500 pg/ml), which showed that, over 4 hr, Amberlite XAD-7 removed 10.3% of the initial LPS and 29.1% of IL-1 alpha, whereas DHP-1 charcoal removed 23.2% of the initial LPS and 65.3% of IL-1 alpha. In vitro plasma ultrafiltration with either polysulfone or polyacrylonitrile membranes, as used clinically in haemodialysis, was performed with recirculation of plasma containing LPS or TNF-alpha. Neither of the substances was filtered to a significant degree. In conclusion, direct removal of these inflammatory mediators from the circulation of patients with multiorgan failure due to fulminant hepatic failure or sepsis would be possible by perfusion of plasma through adsorbents but not by haemodialysis.
使用装有树脂或活性炭吸附剂的小柱进行体外血浆灌注实验，以评估细胞因子和内毒素的清除情况。将125I标记的肿瘤坏死因子-α（TNF-α；500 pg/ml）和白细胞介素-6（IL-6；10 ng/ml）分别加入人血浆中。在4小时的灌注过程中，Amberlite XAD-7树脂去除了初始量TNF-α的32.5%±3.3%（n = 5）和初始量IL-6的71.4%±3.8%（n = 5）。DHP-1聚甲基丙烯酸涂层活性炭去除了TNF-α的17.2%±6.2%（n = 5）和IL-6的48.5%±7.4%（n = 5）。用脂多糖（LPS；100 ng/ml）和白细胞介素-1α（IL-1α；500 pg/ml）进行了初步实验，结果表明，在4小时内，Amberlite XAD-7去除了初始LPS的10.3%和IL-1α的29.1%，而DHP-1活性炭去除了初始LPS的23.2%和IL-1α的65.3%。使用临床上用于血液透析的聚砜或聚丙烯腈膜进行体外血浆超滤，使含有LPS或TNF-α的血浆再循环。这两种物质均未被显著滤过。总之，通过吸附剂灌注血浆，而不是通过血液透析，有可能直接从暴发性肝衰竭或败血症所致多器官功能衰竭患者的循环中清除这些炎症介质。
