Tani T, Hanasawa K, Kodama M
Department of Surgery, Shiga University of Medical Science, Otsu, Japan.
Nihon Geka Gakkai Zasshi. 1989 Sep;90(9):1370-3.
Sepsis and septic shock have been drugs difficult to treat despite many our therapeutic methods. There are many drugs for sepsis, but few can remove or detoxify such sabstances as endotoxin. The polystyrene fiber immobilized polymyxin B (PMX-F) have been invented and it was already confirmed the stability of its bonding. In this paper, mass-productive PMX-F for the clinical application were estimated.
PMX-F adsorbed endotoxin (10ng/ml) from the calf serum, and recombinant tumor necrosis factor (80U/ml) from the serine solution. PMX-F maintained an antimicrobial activities against E.coli sufficiently. Those activities of PMX-F showed significant difference between PMX-F and carrier fiber. But PMX-F could not adsorb histamine and thromboxane B2. In vivo studies: The treatment of endotoxic mongrel dogs showed early recovery in arterial blood pressure, and ameliorated survival rate significantly. In human study, 77-year old male patients who had obstructive jaundice due to recurrent stomach cancer and biliary tract infection by Klebsiella showed sepsis and DIC. During DHP with PMX-F, the change of blood pressure was remarkable better, and platelet counts decreased, but next morning this count recovered completely and he had no hemorrhagic tendency. We believe clinical application of PMX-F is safe and useful.
尽管有许多治疗方法，但脓毒症和脓毒性休克一直难以治疗。治疗脓毒症的药物有很多，但很少有药物能清除内毒素等物质或使其解毒。已经发明了固定有多粘菌素B的聚苯乙烯纤维（PMX-F），并且已经证实了其结合的稳定性。在本文中，对用于临床应用的大量生产的PMX-F进行了评估。
PMX-F从牛血清中吸附内毒素（10ng/ml），并从丝氨酸溶液中吸附重组肿瘤坏死因子（80U/ml）。PMX-F对大肠杆菌保持了足够的抗菌活性。PMX-F的这些活性在PMX-F和载体纤维之间显示出显著差异。但是PMX-F不能吸附组胺和血栓素B2。体内研究：对内毒素杂种犬的治疗显示动脉血压早期恢复，存活率显著改善。在人体研究中，一名77岁男性患者因复发性胃癌导致梗阻性黄疸，并感染了肺炎克雷伯菌引起胆道感染，出现了脓毒症和弥散性血管内凝血。在用PMX-F进行直接血液灌流期间，血压变化明显更好，血小板计数下降，但第二天早上该计数完全恢复，且他没有出血倾向。我们认为PMX-F的临床应用是安全且有用的。
