Himmelein Susanne, Perez Ruiz de Garibay Aritz, Brandel Veronika, Zierfuß Frank, Bingold Tobias Michael
ADVITOS GmbH, Munich, Germany.
Ostbayerische Technische Hochschule Regensburg, Regensburg, Germany.
Intensive Care Med Exp. 2024 Jul 31;12(1):66. doi: 10.1186/s40635-024-00652-5.
IL-6 is a pleiotropic cytokine modulating inflammation and metabolic pathways. Its proinflammatory effect plays a significant role in organ failure pathogenesis, commonly elevated in systemic inflammatory conditions. Extracorporeal blood purification devices, such as the Advanced Organ Support (ADVOS) multi hemodialysis system, might offer potential in mitigating IL-6's detrimental effects, yet its efficacy remains unreported.
We conducted a proof-of-concept in vitro study to assess the ADVOS multi system's efficacy in eliminating IL-6. Varying concentrations of IL-6 were introduced into a swine blood model and treated with ADVOS multi for up to 12 h, employing different blood and concentrate flow rates. IL-6 reduction rate, clearance, and dynamics in blood and dialysate were analyzed.
IL-6 clearance rates of 0.70 L/h and 0.42 L/h were observed in 4 and 12-h experiments, respectively. No significant differences were noted across different initial concentrations. Reduction rates ranged between 40 and 46% within the first 4 h, increasing up to 72% over 12 h, with minimal impact from flow rate variations. Our findings suggest that an IL-6-albumin interaction and convective filtration are implicated in in vitro IL-6 elimination with ADVOS multi.
This study demonstrates for the first time an efficient and continuous in vitro removal of IL-6 by ADVOS multi at low blood flow rates. Initial concentration-dependent removal transitions to more consistent elimination over time. Further clinical investigations are imperative for comprehensive data acquisition.
白细胞介素-6（IL-6）是一种多效性细胞因子，可调节炎症和代谢途径。其促炎作用在器官衰竭发病机制中起重要作用，在全身性炎症状态下通常会升高。体外血液净化设备，如高级器官支持（ADVOS）多血液透析系统，可能在减轻IL-6的有害影响方面具有潜力，但其疗效尚未见报道。
我们进行了一项概念验证性体外研究，以评估ADVOS多系统清除IL-6的疗效。将不同浓度的IL-6引入猪血液模型，并使用ADVOS多系统以不同的血液和浓缩液流速处理长达12小时。分析血液和透析液中IL-6的降低率、清除率及动态变化。
在4小时和12小时的实验中，观察到IL-6清除率分别为0.70 L/h和0.42 L/h。不同初始浓度之间未观察到显著差异。在前4小时内降低率在40%至46%之间，12小时内增至72%，流速变化的影响最小。我们的研究结果表明，IL-6与白蛋白的相互作用及对流过滤参与了ADVOS多系统在体外清除IL-6的过程。
本研究首次证明ADVOS多系统在低血流速率下能高效、持续地在体外清除IL-6。初始浓度依赖性清除随时间转变为更一致的清除。进一步的临床研究对于全面获取数据至关重要。
