Effects of treatment with direct hemoperfusion using a new cytokine abserbent to septic shock

本研究观察了一种能清除炎性细胞因子α-α、IL-Iβ和IL-6的新型吸收剂CTR体外治疗对大鼠内毒素休克后死亡率和炎症反应的影响。方法1)观察大鼠注射内毒素后即刻应用CTR体外治疗的效果。2)评价大鼠注射内毒素后2小时应用CTR体外治疗的效果。3)评价大鼠注射内毒素后应用CI R体外治疗的量效关系。1)注射内毒素后8h，内毒素血症组、对照柱组和CTR组的死亡率分别为92%、92%和14%。2)内毒素血症组、对照组和CTR后处理组8h死亡率分别为83%、83%和33%。3)对照组、四分之三剂量组、半量组和全量组注射内毒素后8h的死亡率分别为92%、58%、42%和17%。CTR半剂量组和全剂量组血浆细胞因子浓度的升高均小于内毒素血症组。结论CTR柱直接血液灌流采集法降低了死亡率，抑制了内毒素血症时的炎症反应。提示CTR柱体外血液净化可用于脓毒症和/或内毒素血症患者。

This research examined effects of the extracorporeal treatment with a new absorbent, CTR, which removed inflammatory cytokines such as THE-alpha, IL-I beta and IL-6, on mortality rate and inflammatory responses to endotoxic shock in rats.<Methods>1) To evaluate the effects of the extracorporeal treatment with CTR immediately after endotoxin injection in rats.2) To evaluate the effects of the extracorporeal treatment with CTR 2 hr after endotoxin injection in rats.3) To evaluate the dose-related effects of the extracorporeal treatment with CI R after endotoxin injection in rats.<Results>1) The mortality rates at 8 hrs after endotoxin injection were 92%, 92%, and 14% for the endotoxemic, control column, and CTR treatment groups, respectively. Hypotension and elevated plasma cytokine concentrations and the infiltration of neutrophils of the lungs were less conspicuous in the CTR treatment group than in the other two groups.2) The mortality rates 8hrs after endotoxin injection were 83%, 83%, and 33% for the endotoxemic, control column, and CTR-posttreatment groups, respectively. The increases of interleukin-6 concentrations were less for the CTR-posttreatment group than the other two groups.3) The mortality rates 8hrs after endotoxin injection were 92%, 58%, 42% and 17% for the control column, quarter dose, half dose, and full dose CTR groups, respectively. The increases in plasma cytokine concentrations were smaller in the half dose and full dose CTR treatment groups than in the endotoxemic group.<Conclusion>Direct hemoperfusion apheresis with CTR column reduced mortality and had inhibitory effects on the inflammatory responses during endotoxemia. These findings suggest that extracorporeal blood purification with CTR column may be available to use for the patients with sepsis and/or endotoxemia.