Plasmadiafiltration ameliorating gut mucosal barrier dysfunction and improving survival in porcine sepsis models

Abstract

BackgroundThe object of this study is to explore whether the plasmadiafiltration (PDF) is more effective in improving the intestinal mucosal barrier function by removing more key large molecular inflammatory mediators and then prolonging the survival time.MethodsTotally, 24 porcine sepsis models induced by cecal ligation and puncture (CLP) operation were randomly divided into three groups: PDF group, high-volume hemofiltration (HVHF) group, and control group, and received 8 h treatment, respectively. The expression of ZO-1 and occludin in intestinal mucosal epithelial cells were detected by immunohistochemistry, and apoptotic protein caspase-3-positive lymphocytes were signed in mesenteric lymph nodes by TUNEL staining. The hemodynamic parameters were measured by invasive cavity detection. The tumor necrosis factor alpha (TNFα) and high-mobility group protein 1 (HMGB1) were tested by ELISA method. And then, the survival curves with all-cause death were compared with three groups.ResultsPDF led to a superior reversal of sepsis-related hemodynamic impairment and serum biochemistry abnormalities and resulted in longer survival time compared with HVHF and control (p < 0.01). Definitive protection from excessive TNF-α and HMGB1 response were only achieved by PDF. A more regular distribution pattern of ZO-1 and occludin along the epithelium was found in PDF animals (p < 0.01). The presence of apoptotic lymphocytes was significantly reduced in the PDF animals (p < 0.01).ConclusionsPDF can effectively eliminate more pivotal inflammatory mediators of TNFα and HMGB1 and reduce the inflammation damage of the intestinal mucosal barrier and apoptosis of lymphocyte then improve the circulation function and prolong the survival time.

Protective effect of emodin on intestinal epithelial tight junction barrier integrity in rats with sepsis induced by cecal ligation and puncture

“…Furthermore, damage to the intestinal mucosa exacerbates bacterial translocation, leading to virulence factors that further activate the host immune inflammatory defence mechanisms, eventually resulting in multiple organ failure and life-threatening clinical symptoms (11). Destruction of the intestinal barrier integrity may be an important pathway which leads to the multiple organ dysfunction caused by sepsis (12). Protecting against intestinal epithelial barrier damage and maintaining intestinal epithelial barrier integrity reduces intestinal permeability and bacterial translocation.…”

Treatment of Hypertriglyceridemia-Induced Acute Pancreatitis With Plasma Diafiltration

“…The most important findings of our research are as follows: (1) PDF can rapidly reduce serum TG in a short period of time, which is key to the successful management of HTG-AP. We achieved 87.2% in TG reduction with 1 to 2 sessions of treatment of our patients, which is faster than in previous reports on double filtration plasmapheresis (from 60% to 70%) or PE (84.5%) 6 and (2) no treatment-related complication occurred.…”

“…Plasma diafiltration (PDF), which used high cutoff hemofilter and diluted plasma as replacement fluid, can significantly decrease middle– and high–molecule-weight mediator levels with low substitution flow, achieving approximately the same effect as that of conventional plasmapheresis. 6 However, no previous reports exist on the treatment of HTG-AP with PDF. Therefore, we designed a retrospective study to evaluate the efficacy and safety of PDF application in combination with routine treatments in 5 HTG-AP patients admitted to the intensive care unit (ICU).…”

Role of microglia in sepsis-associated encephalopathy pathogenesis: an update

“…Sepsis is associated with reduced diversity in the intestinal microbiota, which may play a crucial regulatory role in SAE progression. In sepsis, systemic inflammation, intestinal permeability, and pharmacologic interventions can disturb the diversity of the gut microbiota (114)(115)(116). Changes in the gut microbiota have been implicated in microglial expression.…”