1. Novel Insights into the Direct Removal of Endotoxin by Polymyxin B Hemoperfusion
- Author
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Christina V. Obiezu-Forster, David J. Klein, Alexander D. Romaschin, and Hisataka Shoji
- Subjects
Lipopolysaccharides ,0301 basic medicine ,medicine.drug_class ,Polymyxin ,medicine.medical_treatment ,Sepsis ,03 medical and health sciences ,0302 clinical medicine ,medicine ,Biological fluids ,Animals ,Bovine serum albumin ,Polymyxin B ,Whole blood ,Chromatography ,biology ,Chemistry ,030208 emergency & critical care medicine ,Hematology ,General Medicine ,medicine.disease ,Hemoperfusion ,030104 developmental biology ,Nephrology ,biology.protein ,Cattle ,lipids (amino acids, peptides, and proteins) ,Perfusion ,medicine.drug - Abstract
Aim: To demonstrate the capacity of polymyxin B-direct hemoperfusion (PMX-DHP) column Toraymyxin® 20R (PMX-20R) in removing endotoxin (LPS) from perfused blood, serum and plasma. Methods: Endotoxin-spiked bovine serum or plasma was perfused in PMX-20R as per the recommended performance testing protocol. Samples were taken at various time points to assess the amount of endotoxin removed during a 4-h session. In another set of experiments, FITC-labelled LPS (FITC-LPS) was spiked into a pool of human whole blood, followed by perfusion with the spiked blood for 2 h in order to allow FITC-LPS to bind PMX-20R. The amount of LPS was extracted from the columns and the amount of specifically bound LPS was determined by fluorometry. Results: PMX-20R columns perfused with bovine serum or plasma had an average binding rate of 88%, equivalent to approximately 12 µg of LPS. When PMX-20R was perfused with human whole blood, the columns bound an average of 20 µg of FITC-LPS. Conclusion: PMX-20R can bind LPS in all the biological fluids tested. The calculated binding capacity of 12-20 µg LPS suggests that in septic cases where endotoxin is present in the circulation, PMX-20R is able to adsorb clinically significant levels of endotoxin.
- Published
- 2017
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