Treatment with polymyxin B-immobilized fiber reduces platelet activation in septic shock patients: Decrease in plasma levels of soluble P-selectin, platelet factor 4 and β-thromboglobulin

Nakamura, Tsukasa; Ebihara, Isao; Shoji, Hiromichi; Ushiyama, Chifuyu; Suzuki, Shingo; Koide, Hikaru

doi:10.1007/s000110050442

Cited by 69 publications

(50 citation statements)

References 23 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…An antagonistic effect of PmxB on endotoxic activities of such Ara4N-containing LPSs in relation to interaction between PmxB and the LPSs has not been investigated in detail, but such investigations, like the present study, are necessary to obtain useful information for treatment of infections by bacteria containing such LPSs. Recently, PmxBimmobilized fiber was developed for clinical application in hemoperfusion to eliminate blood endotoxin in septic shock patients (2,21). Based on the information obtained in the present study, PmxB-immobilized fiber is expected to be effective for elimination of B. cepacia LPS, but soluble PmxB is not expected to be effective in suppressing endotoxic activity.…”

Section: Discussionmentioning

confidence: 75%

Unusual Interaction of a Lipopolysaccharide Isolated fromBurkholderia cepaciawith Polymyxin B

et al. 2003

View full text Add to dashboard Cite

We have demonstrated that lipopolysaccharide (LPS) obtained from Burkholderia cepacia, an important opportunistic pathogen, has unique characteristics in both structure and activity. One of the structural characteristics is that the B. cepacia LPS has 4-amino-4-deoxy-L-arabinose (Ara4N) in its inner core region. Polymyxin B (PmxB) is known to act as an LPS antagonist, but LPS with Ara4N is suggested to be PmxB resistant by decreasing the binding capability of PmxB. Interaction of B. cepacia LPS with PmxB was investigated and compared with that of a reference LPS of Salmonella enterica serovar Abortusequi, referred to hereafter as the reference LPS. B. cepacia LPS suffered no suppressive effect of PmxB in its activity to stimulate murine peritoneal macrophages for induction of tumor necrosis factor alpha (TNF-␣) and IL-6 even when the activity of the reference LPS was completely suppressed. A characteristic of B. cepacia LPS is that it has selectively weak interleukin-1␤ (IL-1␤)-inducing activity while activity to induce TNF-␣ and IL-6 has been shown to be as strong as that of the reference LPS. Remarkably, PmxB augmented the IL-1␤-inducing activity of B. cepacia LPS to the level of that of the reference LPS and, in contrast, completely suppressed the strong activity of the reference LPS. Using PmxB-immobilized beads, the adsorbances of these LPSs to the beads were compared, and it was found that B. cepacia LPS bound to PmxB with a high affinity similar to that of the reference LPS. These results indicate an unusual interaction of B. cepacia LPS with PmxB whereby B. cepacia LPS not only allows the binding of PmxB with high affinity, even though it contains Ara4N, but also suffers no suppressive effect of PmxB on its activity. Moreover, a remarkable increase in its IL-1␤-inducing activity was also observed.

show abstract

Section: Discussionmentioning

confidence: 75%

Unusual Interaction of a Lipopolysaccharide Isolated fromBurkholderia cepaciawith Polymyxin B

et al. 2003

View full text Add to dashboard Cite

show abstract

“…Apheresis, which is a selective adsorption technique, can lower the levels of toxins and cytokines in the blood. We and other investigators have reported that polymyxin B-immobilized fiber (PMX-F) therapy is effective in reducing the levels of various cytokines in gram-negative sepsis patients [8, 10, 11]. …”

Section: Discussionmentioning

confidence: 99%

“…Ten patients were treated with PMX-F (Toraymyxin ® , Toray Medical Co., Ltd, Tokyo, Japan) (group A), and conventional treatment was continued in the other 10 patients (group B). PMX-F and the hemoperfusion column have been described previously [8, 9, 10, 11]. To reduce the toxic effect of polymyxin B and derive benefit from the lipopolysaccharide blocking property, polymyxin B was immobilized onto insoluble fibers creating a hemoperfusion column to use as an extracorporeal endotoxin removal device for the treatment of sepsis [8, 9].…”

Section: Methodsmentioning

confidence: 99%

“…The polymyxin B-immobilized fiber (PMX-F) cartridge has been applied safely in sepsis patients without critical adverse effects [8, 9]. We reported previously that PMX-F treatment effectively removes endotoxin in patients with sepsis caused by gram-negative bacteria [10, 11]. Kodama et al [8]reported that PMX-F treatment is effective in patients with MRSA, suggesting that improved status may be due to the removal of a small amount of endotoxin in gram-positive or mixed infection and that such reduction may prove effective in patients with toxic symptoms caused by endotoxin.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Hemoperfusion with Polymyxin B-Immobilized Fiber in Septic Patients with Methicillin-Resistant <i>Staphylococcus aureus</i>-Associated Glomerulonephritis

Nakamura¹,

Ushiyama²,

Suzuki

et al. 2004

Nephron Clin Pract

View full text Add to dashboard Cite

Background/Aims: We investigated whether urinary podocytes are present in septic patients with methicillin-resistant Staphylococcus aureus (MRSA)-associated glomerulonephritis and whether polymyxin B-immobilized fiber (PMX-F) treatment affects proteinuria and urinary podocyte excretion in these patients. Methods: Twenty septic patients with MRSA-associated glomerulonephritis (mean age: 63.7 years) and 80 septic patients whose MRSA infection was not followed by glomerulonephritis (mean age: 60.5 years) were included in this study. All septic patients were treated with fosfomycin sodium, β-lactams, arbekacin sulfate, and teicoplanin, or a combination of these. Twenty septic patients with MRSA-associated glomerulonephritis were randomly assigned to one of two treatments: PMX-F treatment (group A, n = 10) and conventional treatment (group B, n = 10). PMX-F treatment was repeated twice. Results: Urinary podocytes and urinary protein excretion were not detected in MRSA septic patients without glomerulonephritis. However, urinary podocytes (1.7 ± 0.6 cells/ml) and proteinuria (2.6 ± 0.6 g/d) were detected in the 20 septic patients with MRSA-associated glomerulonephritis. Plasma endotoxin levels were decreased from 13.6 ± 4.6 pg/ml to 6.6 ± 2.2 pg/ml (p < 0.05) in group A. Levels in group B, however, showed little difference after treatment. Urinary podocytes were reduced in group A (from 1.8 ± 0.6 cells/ml to 0.4 ± 0.2 cells/ml, p < 0.01) as was urinary protein excretion (from 3.0 ± 0.5 g/d to 0.8 ± 0.4 g/d, p < 0.01) but urinary podocytes and protein excretion levels showed little difference after treatment in group B. Conclusion: PMX-F treatment may be effective in reducing urinary protein and urinary podocyte excretion in septic patients with MRSA-associated glomerulonephritis.

show abstract

“…1 Summary of the main randomised trials assessing influence of PMX on mortality of patients with severe sepsis or septic shock. Only Payen et al's study was considered at low risk of bias [13][14][15][16][17] as prescribed in this population, does not likely portend meaningful survival advantage. Secondly, the ABDOMIX trial did not identify patients with the highest likelihood of deriving benefit from PMX therapy by screening patients for elevated circulating levels of endotoxin.…”

mentioning

confidence: 95%

Balancing the “humors” in severe sepsis: still a role for extracorporeal therapies?

2015

View full text Add to dashboard Cite

Treatment with polymyxin B-immobilized fiber reduces platelet activation in septic shock patients: Decrease in plasma levels of soluble P-selectin, platelet factor 4 and β-thromboglobulin

Abstract: Our findings suggest that soluble P-selectin, PF-4 and betaTG may be associated with septic shock and that PMX-F is effective in reducing these markers in patients with septic shock.

Cited by 69 publications

References 23 publications

Unusual Interaction of a Lipopolysaccharide Isolated fromBurkholderia cepaciawith Polymyxin B

Unusual Interaction of a Lipopolysaccharide Isolated fromBurkholderia cepaciawith Polymyxin B

Hemoperfusion with Polymyxin B-Immobilized Fiber in Septic Patients with Methicillin-Resistant <i>Staphylococcus aureus</i>-Associated Glomerulonephritis

Balancing the “humors” in severe sepsis: still a role for extracorporeal therapies?

Contact Info

Product

Resources

About