Beneficial Effect of Polymyxin B-immobilized Fiber Column (PMX) Hemoperfusion Treatment on Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Seo, Yoshitsugu; Abe, Shinji; Kurahara, Misuzu; Okada, Daisuke; Saito, Yoshinobu; Usuki, Jiro; Azuma, Arata; Koizumi, Kiyoshi; Kudoh, Shoji

doi:10.2169/internalmedicine.45.6018

Cited by 87 publications

(79 citation statements)

References 25 publications

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“…Empirically, AE-IPF has been treated with high-dose corticosteroids, antibiotics, and immunosuppressive agents (6-10). However, these agents provide little bene- (15). In the study, four of six patients who were treated with PMX-DHP showed a dramatic improvement in pulmonary oxygenation and survived for longer than 30 days, while later being successfully weaned from mechanical ventilation.…”

Section: Discussionmentioning

confidence: 94%

“…It has been reported that direct hemoperfusion with PMX (PMX-DHP) improves oxygenation in patients with acute lung injury or acute respiratory distress syndrome (ARDS), which usually manifests diffuse alveolar damage (12)(13)(14). In addition, PMX-DHP has also been reported to have a beneficial impact in AE-IPF patients on the respiratory status and long-term outcome (15)(16)(17)(18)(19). However, it remains unclear whether PMX-DHP treatment is a useful therapeutic option for AE-IPF.…”

Section: Introductionmentioning

confidence: 99%

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Survival from acute exacerbation of idiopathic pulmonary fibrosis with or without direct hemoperfusion with polymyxin B-immobilized fiber column: A retrospective analysis

Oishi

Aoe

Mimura

et al. 2016

1.5 Diffuse Parenchymal Lung Disease

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Objective Acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF) are fatal episodes of acute respiratory worsening of unknown etiology. Previous studies on acute respiratory distress syndrome have shown that direct hemoperfusion with a polymyxin B-immobilized fiber column (PMX-DHP) can have a beneficial effect on the respiratory status. This retrospective study investigated the prognosis and survival outcome of patients with AE-IPF who underwent PMX-DHP. Methods We examined the records of 50 patients with AE-IPF treated in our hospital. All patients received corticosteroid pulse therapy. We compared the disease outcome between 27 patients who underwent PMX-DHP (PMX group) and 23 patients who did not (non-PMX group). The independent predictors of survival were determined using Cox proportional hazards analyses. Results A multivariate analysis of all patients revealed that PMX-DHP therapy was a significant predictor of survival (HR=0.442, 95% CI 0.223-0.873; p=0.019). The 12-month survival rate was significantly higher in the PMX group than in the non-PMX group (41.7% vs. 9.8%; p=0.040). According to a subanalysis of the PMX group, the time from AE-IPF onset to PMX-DHP was a significant predictor of survival (HR=1.080, 95% CI 1.001-1.166; p=0.049). Conclusion PMX-DHP improved the prognosis of AE-IPF. The time from AE-IPF onset to PMX-DHP may therefore be informative for predicting the patient outcome.

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Section: Discussionmentioning

confidence: 94%

Section: Introductionmentioning

confidence: 99%

Survival from acute exacerbation of idiopathic pulmonary fibrosis with or without direct hemoperfusion with polymyxin B-immobilized fiber column: A retrospective analysis

Oishi

Aoe

Mimura

et al. 2016

1.5 Diffuse Parenchymal Lung Disease

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“…However, effective treatments are not well-established and mortality of these patients has been reported to be high during the short course (3, 6, (8)(9)(10)(11). Here, we report two cases of acute exacerbation of IP treated with PMX hemoperfusion treatment.…”

Section: Acute Exacerbation Of Idiopathic Pulmonary Fibrosis (Ipf) Ismentioning

confidence: 88%

Two Cases of Acute Exacerbation of Interstitial Pneumonia Treated with Polymyxin B-immobilized Fiber Column Hemoperfusion Treatment

et al. 2007

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“…Recently, direct hemoperfusion with a polymyxin Bimmobilized fiber cartridge (PMX-DHP) has been reported to have a beneficial impact on the respiratory status and long-term outcome of patients with AE-IPF (Seo et al 2006;Abe et al 2010;Enomoto et al 2008;Hara et al 2011). Oishi et al reported that proinflammatory, profibrotic, and proangiogenic cytokines, including TGF-β were eluted from PMX fibers used for the treatment of AE-IPF and suggested that adsorption of such cytokines onto PMX fibers might be one of the mechanisms of action involved.…”

Section: Discussionmentioning

confidence: 99%

Serum heat shock protein 47 levels are elevated in acute exacerbation of idiopathic pulmonary fibrosis

Kakugawa

Yokota

Ishimatsu

et al. 2013

Cell Stress and Chaperones

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Little is known about the pathophysiology of acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF). Heat shock protein 47 (HSP47), a collagen-specific molecular chaperone, is essential for biosynthesis and secretion of collagen molecules. Previous studies in experimental animal fibrosis models have shown that downregulation of HSP47 expression reduces collagen production and diminishes fibrosis progression. In this study, serum HSP47 levels were evaluated to elucidate pathogenic differences involving HSP47 between AE-IPF and stable (S)-IPF. -013-0411-5 and lactate dehydrogenase (LDH) were measured. Immunohistochemical analysis of lung HSP47 expression was determined in biopsy and autopsy tissues diagnosed as diffuse alveolar damage (DAD) and usual interstitial pneumonia (UIP). Serum levels of HSP47 were significantly higher in AE-IPF than in S-IPF patients, whereas serum levels of KL-6, SP-A, and SP-D did not differ significantly. Receiver operating characteristic curves revealed that HSP47 was superior for discriminating AE-IPF and S-IPF. The cutoff for HSP47 resulting in the highest diagnostic accuracy was 559.4 pg/mL; sensitivity, specificity, and diagnostic accuracy were 100.0 %, 93.9 %, and 96.2 %, respectively. Immunohistochemical analysis revealed that pulmonary HSP47 expression was greater in DAD than UIP tissues. Serum HSP47 was significantly higher in AE-IPF than in S-IPF patients, suggesting that underlying fibrogenic mechanisms involving HSP47 differ in the two conditions.Cell Stress and Chaperones (2013) 18:581-590 DOI 10.1007/s12192

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Beneficial Effect of Polymyxin B-immobilized Fiber Column (PMX) Hemoperfusion Treatment on Acute Exacerbation of Idiopathic Pulmonary Fibrosis

Abstract: Objective This study was aimed to investigate the effect of polymyxin B-immobilized fiber column (PMX) hemoperfusion treatment on the acute exacerbation of idiopathic pulmonary fibrosis (IPF). Patients and Methods

Cited by 87 publications

References 25 publications

Survival from acute exacerbation of idiopathic pulmonary fibrosis with or without direct hemoperfusion with polymyxin B-immobilized fiber column: A retrospective analysis

Survival from acute exacerbation of idiopathic pulmonary fibrosis with or without direct hemoperfusion with polymyxin B-immobilized fiber column: A retrospective analysis

Two Cases of Acute Exacerbation of Interstitial Pneumonia Treated with Polymyxin B-immobilized Fiber Column Hemoperfusion Treatment

Serum heat shock protein 47 levels are elevated in acute exacerbation of idiopathic pulmonary fibrosis

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