Multiscale Biofluidic and Nanobiotechnology Approaches for Treating Sepsis in Extracorporeal Circuits

Abstract

Infectious diseases and their pandemics periodically attract public interests due to difficulty in treating the patients and the consequent high mortality. Sepsis caused by an imbalanced systemic inflammatory response to infection often leads to organ failure and death. The current therapeutic intervention mainly includes "the sepsis bundles," antibiotics (antibacterial, antiviral, and antifungal), intravenous fluids for resuscitation, and surgery, which have significantly improved the clinical outcomes in past decades; however, the patients with fulminant sepsis are still in desperate need of alternative therapeutic approaches. One of the potential supportive therapies, extracorporeal blood treatment, has emerged and been developed for improving the current therapeutic efficacy. Here, I overview how the treatment of infectious diseases has been assisted with the extracorporeal adjuvant therapy and the potential utility of various nanobiotechnology and microfluidic approaches for developing new auxiliary therapeutic methods.

Cytokine Blood Filtration Responses in COVID-19

“…While CytoSorb does not destroy or remove the virus, it has been used in more than 80,000 EU procedures as an approved treatment for cytokine storms. It has been distributed worldwide to 58 countries, helping doctors control severe inflammation, help reverse shocks, and improve breathing and other functions of the heart, which are some of the primary reasons patients suffer from CO­VID-19 infection [ 3 , 11 ].…”

Biomedical application, drug delivery and metabolic pathway of antiviral nanotherapeutics for combating viral pandemic: A review

“…On the other hand, gold nanoparticles (AuNPs) may also exert their antiviral efficacy through hindering of gp120 fusion to CD4 that are surrounded by capping agents (encapsulated AuNPs) ( Table 1 ). Hybridized and charged AuNPs render virucidal mechanism after associating with nano-based formulation and mimicking peroxidase enzymatic reaction, where inhibited viral entry is facilitated by blocking of transcription within the host cell ( Isida, 2019 ; Kumar et al, 2020 , Kumar et al, 2020 , Kumar et al, 2020 ; Kang, 2020 ).…”

“…Most of the clinical trials were in experimental stages ( in vitro phase ) and some of them have received green signals as a post-exposure prophylaxis (i.e.advanced drug treatment options for SARS-CoV) ( Table 3 ). Many researchers ( Agostini et al, 2018 ; Kang, 2020 ) have found that corticosteroids with interferon alfacon-1 may have effective antiviral actions for such group of coronaviruses having RNA-dependent RNA polymerases. Gao et al (2020) and Gordon et al (2020) have reported that niclosamide, novavax and geovax might have the potential to inhibit virus-cell entry and virus replication.…”

“…The use of nanotechnology has gained popularity in medical oncology though it has been reported that some chemotherapeutic agents do not possess target specific actions for malignant cells ( Iravani, 2020 ; Ishida, 2019 ). The mode of action of such nano-based therapeutic agents can be categorised based on the permeability of vasculature or attachment of bioactive ligands to the selective nanotherapeutics (active targeting for virus infections) ( Kalantar-Zadeh et al, 2020 ; Kang, 2020 ).…”

Clearance of ESKAPE Pathogens from Blood Using Bacterially Activated Macrophage Membrane‐Coated Silicon Nanowires

“…[6,7] Severity of symptoms can be aggravated by an overwhelming cytokine storm associated with the presence of intact bacteria or of pathogen-associated molecular patterns (PAMPs) of fragmented bacteria in the blood stream. [8] Treatment includes source removal and infectioncontrol. [1] Infection-sources can be either an infection elsewhere in the body, skinpenetrating intravascular catheters, [9] ventilators, [10] or hemodialysis devices.…”