Lorenzin Anna, Perin Natascha, de Cal Massimo, Zanella Monica, Ronco Claudio
Department of Nephrology Dialysis and Transplantation, San Bortolo Hospital, Vicenza, Italy.
International Renal Research Institute of Vicenza (IRRIV), San Bortolo Hospital, Vicenza, Italy.
Blood Purif. 2025 Jul 14:1-9. doi: 10.1159/000547419.
Endotoxin, also referred to as lipopolysaccharide (LPS), is a major stimulus of the inflammatory response capable of leading to sepsis and septic shock. Extracorporeal blood purification therapies are increasingly employed in the treatment of sepsis. Timely and thorough removal of endotoxin and cytokines can help mitigate the inflammatory cascade during septic shock. Hemoadsorption (HA) is a promising approach to achieve this goal. In this study, we analyzed different prototypes of a new CA cartridge: we performed in vitro circulations to define endotoxin and cytokine removal capacity.
In vitro HA was performed using GALILEO testing platform, and customized circuits with mini-modules of CA cartridge were prepared. A batch of 500 mL of blood preconditioned with LPS was utilized for each circulation. We collected samples at different time points: endotoxin activity and removal ratio (RR) of LPS, interleukin 6 (IL-6), and interleukin-1 beta (IL-1β) were assessed.
The prototypes showed different performances, highlighting promising adsorption affinity toward the target molecules. A potentially clinically meaningful reduction of endotoxin activity by CA mini-module was observed. Concentration of the LPS, and cytokines IL-6 and IL-1β showed a significant reduction over time, as confirmed by the RRs.
Our experiments allowed to characterize the prototypes in terms of adsorption capacity for both endotoxin and cytokines. After this preliminary approach, the final CA mini-module was tested under the same experimental conditions and displayed excellent adsorption capacity, indicating its potential application for endotoxin removal.
内毒素，也被称为脂多糖（LPS），是炎症反应的主要刺激物，能够导致脓毒症和脓毒性休克。体外血液净化疗法越来越多地用于脓毒症的治疗。及时、彻底地清除内毒素和细胞因子有助于减轻脓毒性休克期间的炎症级联反应。血液吸附（HA）是实现这一目标的一种有前景的方法。在本研究中，我们分析了一种新型CA柱的不同原型：我们进行了体外循环以确定内毒素和细胞因子的清除能力。
使用GALILEO测试平台进行体外血液吸附，并制备了带有CA柱微型模块的定制回路。每次循环使用一批500 mL用LPS预处理的血液。我们在不同时间点采集样本：评估LPS、白细胞介素6（IL-6）和白细胞介素-1β（IL-1β）的内毒素活性和清除率（RR）。
这些原型表现出不同的性能，对目标分子显示出有前景的吸附亲和力。观察到CA微型模块对内毒素活性有潜在的临床意义的降低。LPS以及细胞因子IL-6和IL-1β的浓度随时间显著降低，清除率证实了这一点。
我们的实验能够在对内毒素和细胞因子的吸附能力方面对这些原型进行表征。经过这种初步方法后，最终的CA微型模块在相同实验条件下进行了测试，显示出优异的吸附能力，表明其在内毒素清除方面的潜在应用。
