Maeda Hayata, Tomisawa Narumi, Jimbo Yoichi, Harii Norikazu, Matsuda Kenichi
Nikkiso Co., Ltd., Shibuya-ku, Tokyo, Japan.
Department of Emergency and Critical Care Medicine, Faculty of Medicine, University of Yamanashi, Chuo, Yamanashi, Japan.
J Artif Organs. 2017 Dec;20(4):335-340. doi: 10.1007/s10047-017-0991-4. Epub 2017 Sep 11.
Recently, intensive care physicians have focused on continuous hemodiafiltration with a cytokine-adsorbing hemofilter in the treatment of sepsis. We aimed to establish extracorporeal circulation in a rat sepsis model to evaluate the cytokine removal properties of mini-modules using two types of membrane materials. Rats were divided into polyester polymer alloy (PEPA) and cellulose triacetate (CTA) groups as membrane materials of mini-modules. One hour after 0.1 mg/kg of lipopolysaccharide administration, continuous hemofiltration (CHF) was started in each group. Plasma interleukin-6 (IL-6), an important mediator of sepsis, was measured over time during hemofiltration. The peak IL-6 concentration in PEPA group was approximately 13,000 pg/mL, in comparison to approximately 31,000 pg/mL in CTA group. IL-6 clearance in PEPA group was much more than CTA group. Since IL-6 was not detected in the filtrate in PEPA group, it was considered that IL-6 was adsorbed to the membrane. In conclusion, our results suggest that CHF with PEPA hemofilter can be suitable for removing IL-6 from the blood stream efficiently.
最近，重症监护医师专注于使用细胞因子吸附血液滤过器进行持续血液透析滤过治疗脓毒症。我们旨在在大鼠脓毒症模型中建立体外循环，以评估使用两种膜材料的微型模块的细胞因子清除特性。将大鼠分为作为微型模块膜材料的聚对苯二甲酸乙二醇酯聚合物合金（PEPA）组和三醋酸纤维素（CTA）组。在给予0.1mg/kg脂多糖1小时后，每组开始进行持续血液滤过（CHF）。在血液滤过期间，随时间测量血浆白细胞介素-6（IL-6），这是脓毒症的一种重要介质。PEPA组的IL-6峰值浓度约为13,000pg/mL，而CTA组约为31,000pg/mL。PEPA组的IL-6清除率远高于CTA组。由于在PEPA组的滤液中未检测到IL-6，因此认为IL-6被吸附到了膜上。总之，我们的结果表明，使用PEPA血液滤过器进行CHF可以有效地从血流中清除IL-6。
