Cytokine dialysis:: An ex vivo study
Cytokine dialysis:: An ex vivo study
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DOI：
10.1097/00002480-200211000-00013
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发表时间：
2002-11-01
期刊：
影响因子：
4.2
通讯作者：
Goehl, H
中科院分区：
文献类型：
--
作者：
Uchino, S;Bellomo, R;Goehl, H
为了验证使用新的大孔膜透析将实现有效的细胞因子去除的假设，6名志愿者的血液与内毒素(1 Mg)孵育，然后用聚酰胺膜(标称截止值：100 kDa)通过闭合循环进行循环。在开始循环时、2小时和4小时后，以1或9 L/小时的透析液流量进行血液透析。IL-1β、IL-6、IL-8、肿瘤坏死因子-α、白蛋白的峰值浓度比分别为0.92、0.67、0.94、0.33、0.11。所有细胞因子和白蛋白的透析液/血浆比值随着透析液流量的增加而降低(P<0.05)。L/小时的透析液流量从1增加到9。然而，随着透析液流量的增加，IL-1β、IL-6和IL-8的清除量显著提高(p<；0.01)。肿瘤坏死因子-α清除量没有增加(不显著)，白蛋白清除量减少(p<；0.01)。在9 L/小时时，IL-1β、IL-6、IL-8、肿瘤坏死因子-α、白蛋白的峰值清除量分别为33ml/min、19、51、11、1.2ml/min。未见细胞因子的吸附。我们得出结论，细胞因子透析可以通过具有高截止点的膜来实现，而白蛋白损失可以忽略不计。这些发现支持了这种新的血液净化方法在脓毒症中的技术可行性。
To test the hypothesis that dialysis using a new large pore membrane would achieve effective cytokine removal, blood from six volunteers was incubated with endotoxin (1 mg) and then circulated through a closed circuit with a polyamide membrane (nominal cut-off: 100 kDa). Hemodialysis was conducted at 1 or 9 L/hr of dialysate flow at the start of circulation and after 2 and 4 hours. The peak dialysate/plasma concentration ratios were 0.92 for interleukin (IL-1beta, 0.67 for IL-6, 0.94 for IL-8, 0.33 for tumor necrosis factor (TNF)-alpha, and 0.11 for albumin. The dialysate/plasma ratios for all cytokines and albumin were decreased with increased dialysate flow from I to 9 L/hr (p < 0.05). Clearances for IL-1beta, IL-6, and IL-8, however, were significantly improved with increased dialysate flow (p < 0.01). There was no increase in TNF-alpha clearance (not significant) and a decrease in albumin clearance (p < 0.01). The peak clearance at 9 L/hr was 33 ml/min for IL-1beta, 19 for IL-6, 51 for IL-8, 11 for TNF-alpha, and 1.2 for albumin. No adsorption of cytokines was observed. We conclude that cytokine dialysis is achievable through a membrane with a high cut-off point with negligible albumin loss. These findings support the technical feasibility of this new approach to blood purification in sepsis.