Effect of hemoperfusion with polymyxin B-immobilized fiber on plasma endothelin-1 and endothelin-1 mRNA in monocytes from patients with sepsis

被引:28
作者
Ebihara, I
Nakamura, T
Shimada, N
Shoji, H
Koide, H
机构
[1] Koto Hosp, Dept Med, Koto Ku, Tokyo 136, Japan
[2] Toray Med Co Ltd, Artificial Organs Div, Tokyo, Japan
关键词
endotoxemia; PMX-F; endothelin; cytokine; nitric oxide;
D O I
10.1016/S0272-6386(98)70069-1
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Hemoperfusion using polymyxin B-immobilized fiber (PMX-F) is reported to be an effective treatment for sepsis. The aim of the present study is to assess whether plasma endothelin-1 (ET-1) and ET-1 messenger RNA (mRNA) levels in peripheral-blood monocytes are altered in patients with sepsis and whether PMX-F treatment affects plasma ET-1 and monocyte ET-1 mRNA levels. Sixteen patients with sepsis and 20 healthy volunteers were included in this study. Plasma ET-1 concentration was measured by radioimmunoassay (RIA), and plasma levels of transforming growth factor-beta (TGF-beta), tumor necrosis factor-alpha (TNF-alpha), and interleukin-1 beta (IL-1 beta) were measured by enzyme-linked immunosorbent assay (ELISA). Sixteen patients with sepsis were treated with direct hemoperfusion using PMX-F columns. Blood endotoxin levels decreased significantly from 35 to 10 pg/mL after two treatments of direct hemoperfusion, each for 2 hours. Patients with sepsis showed significantly increased levels of plasma ET-1 (P < 0.001) and monocyte ET-1 mRNA(P < 0.001) compared with healthy volunteers. However, no differences in plasma levels of TGF-beta, TNF-alpha, and IL-1 beta existed between patients with sepsis and healthy volunteers. Increased plasma ET-1 levers and monocyte ET-1 mRNA levels in patients with sepsis decreased significantly after PMX-F treatment (P < 0.01). These data suggest that the secretion of ET-1 from peripheral-blood monocytes may be stimulated by endotoxin, and PMX-F treatment may be effective in reducing ET-1 secretion in patients with sepsis. (C) 1998 by the National Kidney Foundation, Inc.
引用
收藏
页码:953 / 961
页数:9
相关论文
共 57 条
[1]  
Abel J, 1996, EUR J HAEMATOL, V57, P359
[2]   TREATMENT OF SEPSIS BY EXTRACORPOREAL ELIMINATION OF ENDOTOXIN USING POLYMYXIN B-IMMOBILIZED FIBER [J].
AOKI, H ;
KODAMA, M ;
TANI, T ;
HANASAWA, K .
AMERICAN JOURNAL OF SURGERY, 1994, 167 (04) :412-417
[3]   Monocyte response to bacterial toxins, expression of cell surface receptors, and release of anti-inflammatory cytokines during sepsis [J].
Astiz, M ;
Saha, D ;
Lustbader, D ;
Lin, R ;
Rackow, E .
JOURNAL OF LABORATORY AND CLINICAL MEDICINE, 1996, 128 (06) :594-600
[4]  
BATTISTINI B, 1993, LAB INVEST, V68, P600
[5]   DEFINITIONS FOR SEPSIS AND ORGAN FAILURE AND GUIDELINES FOR THE USE OF INNOVATIVE THERAPIES IN SEPSIS [J].
BONE, RC ;
BALK, RA ;
CERRA, FB ;
DELLINGER, RP ;
FEIN, AM ;
KNAUS, WA ;
SCHEIN, RMH ;
SIBBALD, WJ .
CHEST, 1992, 101 (06) :1644-1655
[6]  
BONE RC, 1995, CRIT CARE MED, V23, P1004
[7]   GENOMIC SEQUENCING [J].
CHURCH, GM ;
GILBERT, W .
PROCEEDINGS OF THE NATIONAL ACADEMY OF SCIENCES OF THE UNITED STATES OF AMERICA-BIOLOGICAL SCIENCES, 1984, 81 (07) :1991-1995
[8]   INACTIVATION OF ENDOTOXIN BY POLYMYXIN-B [J].
COOPERSTOCK, MS .
ANTIMICROBIAL AGENTS AND CHEMOTHERAPY, 1974, 6 (04) :422-425
[9]   Endothelin-1 and endothelin-4 stimulate monocyte production of cytokines [J].
Cunningham, ME ;
Huribal, M ;
Bala, RJ ;
McMillen, MA .
CRITICAL CARE MEDICINE, 1997, 25 (06) :958-964
[10]  
CYBULSKY AV, 1993, J AM SOC NEPHROL, V3, P1398