Reduction in Serum High Mobility Group Box-1 Level by Polymyxin B-Immobilized Fiber Column in Patients with Idiopathic Pulmonary Fibrosis with Acute Exacerbation

Abe, Shinji; Hayashi, Hiroki; Seo, Yoshitsugu; Matsuda, Kuniko; Kamio, Koichiro; Saito, Yoshinobu; Usuki, Jiro; Azuma, Arata; Kudoh, Shoji; Gemma, Akihiko

doi:10.1159/000330325

Cited by 71 publications

(53 citation statements)

References 48 publications

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“…Both approaches are typically followed by a rapid taper and cessation of prednisone within several weeks, based on the rationale that chronic prednisone use is likely harmful in IPF [9]. Several other investigational agents have been studied in AE-IPF including polymyxin B-immobilised fibre cartridge [61][62][63][64], tacrolimus [65] and cyclosporine [66][67][68]; however, there are currently insufficient data to support the routine use of these medications.…”

Section: Managementmentioning

confidence: 99%

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

et al. 2015

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The goal of this review is to summarise the clinical features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis (AE-IPF). AE-IPF has previously been defined based on clinical and radiological features that include the subacute onset of dyspnoea, bilateral ground glass changes on chest high-resolution computed tomography, and the absence of an identifiable aetiology. The annual incidence of AE-IPF is typically reported at 5-15%, but is less common in mild disease. Features of diffuse alveolar damage are present when a biopsy is performed. Idiopathic pulmonary fibrosis (IPF) patients with acute respiratory worsening are often initially treated with high dose corticosteroids and antimicrobials; however, there are no clear data to support these therapies, and the short-term mortality of AE-IPF is ∼50%. Recent studies have shown that the features and prognosis of AE-IPF are similar to other causes of acute respiratory worsening, including infection, aspiration, air pollution and mechanical injury to the alveolar epithelium. Based on this emerging evidence, we propose a novel approach to the classification of acute respiratory worsening events in patients with IPF that focuses on clinical and radiological findings consistent with an underlying pathobiology of diffuse alveolar damage. @ERSpublications A review summarising the features, management, and prognosis of acute exacerbations of idiopathic pulmonary fibrosis

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Section: Managementmentioning

confidence: 99%

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

et al. 2015

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“…Initially, PMX‐DHP was developed for removing endotoxins from the blood. However, it was also found to be effective in absorbing activated neutrophils and blood matrix metalloproteinase‐9 (MMP‐9),6 or high mobility group box‐1 7. Therefore, PMX‐DHP was beneficial in patients with not only gram‐negative bacterial infections but also acute exacerbation of idiopathic pulmonary fibrosis 6, 7.…”

Section: Discussionmentioning

confidence: 99%

“…However, it was also found to be effective in absorbing activated neutrophils and blood matrix metalloproteinase‐9 (MMP‐9),6 or high mobility group box‐1 7. Therefore, PMX‐DHP was beneficial in patients with not only gram‐negative bacterial infections but also acute exacerbation of idiopathic pulmonary fibrosis 6, 7. Matrix metalloproteinase‐9 is an inducible enzyme produced mainly by mononuclear phagocytes and stimulated neutrophils, and its elevation is affected by the augmentation of synthesis and/or secretion of this enzyme by inflammatory cells in response to infections 8.…”

Section: Discussionmentioning

confidence: 99%

Efficacy of direct hemoperfusion with a polymyxin B‐immobilized fiber column in miliary tuberculosis

Kawano

Nagashima

Morimoto

et al. 2016

Acute Medicine & Surgery

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CaseA 75‐year‐old woman presented with a 10‐day history of intermittent fever, general fatigue, and progressive dyspnea. Although she had a low PaO2/FIO2 ratio, the cause of acute respiratory distress syndrome was not clear until day 9 in hospital.OutcomeWe treated the patient with direct hemoperfusion with a polymyxin B‐immobilized fiber column incidentally; the PaO2/FIO2 ratio improved following this therapy. Acid‐fast bacilli, which were not seen in the sputum on admission, were detected in cultures from sputum, urine, bone marrow, liver biopsy, and blood samples, with a real‐time polymerase chain reaction assay confirming tuberculosis. She was immediately transferred to a specialized tuberculosis hospital, and after a 3‐month treatment, was discharged.ConclusionTreatment with polymyxin B‐immobilized fiber column may provide good results for pulmonary oxygenation in acute respiratory distress syndrome caused by tuberculosis.

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“…Based on the results of both comparisons, it is very likely that the KKT column can reduce plasma HMGB1 levels in swine. There have been several reports showing a reduction of plasma HMGB1 levels after hemoperfusion with the Toraymyxin column [18,19]. However, in these studies, the comparison of HMGB1 levels was performed only before and after hemoperfusion, and HMGB1 levels were not compared with and without the column nor at the inlet versus the outlet of the column.…”

Section: Discussionmentioning

confidence: 99%

Hemoadsorption of High-Mobility Group Box Chromosomal Protein 1 Using a Column for Large Animals

Nishiyama

Shinoda²,

Tanabe

et al. 2013

Eur Surg Res

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Background: High-mobility group box chromosomal protein 1 (HMGB1) has recently been identified as an important mediator of various kinds of acute and chronic inflammation. A method for efficiently removing HMGB1 from thesystemic circulation could be a promising therapy for HMGB1-mediated inflammatory diseases. Materials and Methods: In this study, we produced a new adsorbent material by chemicallytreating polystyrene fiber. We first determined whether the adsorbent material efficiently adsorbed HMGB1 in vitro using a bovine HMGB1 solution and a plasma sample from a swine model of acute liver failure. We then constructed a column by embedding fabric sheets of the newly developed fibers into a cartridge and tested the ability of the column to reduce plasma HMGB1 levels during a 4-hour extracorporeal hemoperfusion in a swine model of acute liver failure. Results: The in vitro adsorption test of the new fiber showed high performance for HMGB1 adsorption (96% adsorption in the bovine HMGB1 solution and 94% in the acute liver failure swine plasma, 2 h incubation at 37°C; p < 0.05 vs. incubation with no adsorbent). In the in vivo study, the ratio of the HMGB1 concentration at the outlet versus the inlet of the column was significantly lower in swine hemoperfused with the newlydeveloped column (53 and 61% at the beginning and end of perfusion, respectively) than in those animals hemoperfused with the control column (94 and 93% at the beginning and end of perfusion, respectively; p < 0.05). Moreover, the normalized plasma level of HMGB1 was significantly lower during perfusion with the new column than with the control column (p < 0.05 at 1, 2, and 3 h after initiation of perfusion). Conclusion: These data suggest that the newly developed column has the potential to effectively adsorb HMGB1 during hemoperfusion in swine.

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Reduction in Serum High Mobility Group Box-1 Level by Polymyxin B-Immobilized Fiber Column in Patients with Idiopathic Pulmonary Fibrosis with Acute Exacerbation

Cited by 71 publications

References 48 publications

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

Acute exacerbation of idiopathic pulmonary fibrosis: shifting the paradigm

Efficacy of direct hemoperfusion with a polymyxin B‐immobilized fiber column in miliary tuberculosis

Hemoadsorption of High-Mobility Group Box Chromosomal Protein 1 Using a Column for Large Animals

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