Schmidt Julius J, Jahn Janine, Golla Paulina, Hafer Carsten, Kielstein Jan T, Kielstein Heike
Department of Internal Medicine, Division of Nephrology and Hypertension, Medical School Hannover, Carl-Neuberg-Strasse 1, 30625 Hannover, Germany.
Department of Anatomy and Cell Biology, Faculty of Medicine, Martin Luther University Halle-Wittenberg, Halle, Germany.
BMC Obes. 2015 Sep 30;2:37. doi: 10.1186/s40608-015-0067-z. eCollection 2015.
Aside from well-established inflammatory mediators adipokines have recently been found to play an important role in a variety of immunologic diseases. Therapeutic plasma exchange (TPE) is an established treatment modality for the acute removal of pathophysiological relevant disease mediators. The aim of this study was to determine adipokine removal during TPE therapy.
21 Caucasian patients (10 females, 11 males) with an indication for TPE using albumin as exchange fluid received two consecutive TPE sessions. Blood samples for measurement of resistin, leptin, sICAM-1, sCD40L, MCP-1, and sTNF-R were drawn before and at the end of each TPE session. Samples from the total removed plasma were collected at the end of every treatment.
We found a significant reduction in pre- vs. post-TPE plasma concentrations for sICAM-1 (517 ± 246 vs. 260 ± 159 ng/ml, p < 0.0001), sTNF-R (8.1 ± 6.4 vs. 5.7 ± 3.9 ng/ml, p < 0.05), and resistin plasma levels (14.3 ± 6.9 vs. 9.5 ± 4.7 ng/ml, p < 0.001). Solely sICAM-1 reduction persisted for 25 ± 5 h between the first and second TPE treatment, while the other investigated mediators increased to baseline levels. Substantial amounts of all measured mediators could be recovered from the removed plasma.
TPE provides a persistent reduction in sICAM-1 levels and temporarily affects several adipokine and cytokine plasma levels. Our findings are of importance not only for the interpretation of blood levels of cytokines in patients undergoing TPE but provide solid evidence that TPE markedly decreases sICAM-1.
除了公认的炎症介质外，脂肪因子最近被发现在多种免疫疾病中起重要作用。治疗性血浆置换（TPE）是一种用于急性清除病理生理相关疾病介质的既定治疗方式。本研究的目的是确定TPE治疗期间脂肪因子的清除情况。
21名白种人患者（10名女性，11名男性）因TPE适应证使用白蛋白作为置换液接受了连续两次TPE治疗。在每次TPE治疗前和结束时采集血样，用于检测抵抗素、瘦素、可溶性细胞间黏附分子-1（sICAM-1）、可溶性CD40配体（sCD40L）、单核细胞趋化蛋白-1（MCP-1）和可溶性肿瘤坏死因子受体（sTNF-R）。在每次治疗结束时收集全部去除血浆的样本。
我们发现TPE治疗前后血浆中sICAM-1（517±246 vs. 260±159 ng/ml，p<0.0001）、sTNF-R（8.1±6.4 vs. 5.7±3.9 ng/ml，p<0.05）和抵抗素血浆水平（14.3±6.9 vs. 9.5±4.7 ng/ml，p<0.001）有显著降低。仅sICAM-1的降低在第一次和第二次TPE治疗之间持续25±5小时，而其他研究的介质则升高至基线水平。所有测量的介质中有大量可从去除的血浆中回收。
TPE可使sICAM-1水平持续降低，并暂时影响几种脂肪因子和细胞因子的血浆水平。我们的发现不仅对于解释接受TPE治疗患者的细胞因子血水平具有重要意义，而且提供了确凿证据表明TPE可显著降低sICAM-1。
