A Method for Stabilizing the Proportion of the Reduced Form of Albumin During Cell‐Free and Concentrated Ascites Reinfusion Therapy in Patients with Malignant Ascites

Abstract

Cell‐free and concentrated ascites reinfusion therapy (CART) is used to treat malignant ascites. However, the qualities of albumin in malignant ascites, such as antioxidative activity, may decrease owing to oxidative stress caused by cancer cells and inflammatory reactions. We investigated the fraction percentages of mercaptalbumin (HMA%, reduced form) and non‐mercaptalbumin (HNA%, oxidized form) in malignant ascites from 21 patients who received CART and compared the HMA% in the malignant ascites and human serum albumin (HSA) preparations. HMA% of albumin in malignant ascites (22.5%) was significantly lower than that in HSA preparation (42.2%). To ensure a high HMA%, we added L‐cysteine to the paracentesis‐treated ascites followed by dialysis 1 h later. As a result, the HMA% of albumin in malignant ascites was increased to 59.1%. Our results suggest that using this method in CART will improve patient's albumin quality.

Serum Albumin Redox States: More Than Oxidative Stress Biomarker

“…−80 • C, but ALB oxidation proceeds spontaneously at >−30 • C and the oxidation intensifies as the storage temperature increases [10]. Low molecular weight compounds surrounding serum ALB are likely responsible for the instability as described above [52]. This is a serious problem for securing the credibility of ALB redox state analysis.…”

“…They also treated GSH to human serum ALB, and found an increase in HMA level, indicating a reverse/reducing reaction where a mix disulfide on Cys34 of HNA-1 was converted to a free thiol residue (formation of HMA). This research group conducted similar experiments in rat serum ALB [ [52]. Notably, the increased HMA level was maintained as long as for 24 h when the low molecular weight fraction was removed by dialysis before the incubation, whereas the HMA level decreased and HNA-1 level increased again when the incubation was made without dialysis.…”

Development of a novel automatic ascites filtration and concentration equipment with multi‐ring‐type roller pump units for cell‐free and concentrated ascites reinfusion therapy

“…The protein, albumin, and IgG recovery rates (dose) were 72.9%, 72.9%, and 71.2% (65.9 g, 34.9 g, and 13.2 g), respectively. These values were equivalent to or greater than the reported levels 2,6‐10,13‐16,20‐25 . The protein recovery rate decreases due to the following causes: (a) discontinuation of ascites processing due to clogging of the filtration or concentration filters; (b) loss of remaining ascites in the filters and circuit after ascites processing is completed; (c) loss of ascites due to washing of the filtration filter; and (d) protein adsorption to filter membrane.…”

“…M-CART can prevent TMPs higher than the set value from being applied to the hollow fibers of the filtration filter by the automatic two-way drainage washing levels. 2,[6][7][8][9][10][13][14][15][16][20][21][22][23][24][25] The protein recovery rate decreases due to the following causes: (a) discontinuation of ascites processing due to clogging of the filtration or concentration filters; (b) loss of remaining ascites in the filters and circuit after ascites processing is completed; (c) loss of ascites due to washing of the filtration filter; and (d) protein adsorption to filter membrane. By M-CART, the total amount of ascites can be processed by automatic washing of clogged filtration filter and self-regulation of the concentration ratio.…”

Effects of N‐acetyl‐L‐tryptophan on desorption of the protein‐bound uremic toxin indoxyl sulfate and effects on uremic sarcopenia

“…In addition, L-NAT concentrations were measured in the pooled sera at the end of the in vitro experiments. When the redox rate of HSA was measured using high-pressure liquid chromatography (Shodex Asahipak ES-502N, Showa Denko K.K., Tokyo), an L-NAT peak appeared in the chromatogram, and the L-NAT concentration was obtained from the peak area [13].…”