Skip to main content
Top
Published in: Intensive Care Medicine 9/2004

01-09-2004 | Brief Report

Effect of polymyxin B-immobilized fiber on bone resorption in patients with sepsis

Authors: Tsukasa Nakamura, Yasuhiro Kawagoe, Takaharu Matsuda, Hikaru Koide

Published in: Intensive Care Medicine | Issue 9/2004

Login to get access

Abstract

Objective

To analyze the effects of polymyxin B-immobilized fiber (PMX-F) on bone resorption in septic patients.

Design and setting

Observational prospective study in intensive care units of a general hospital.

Patients and participants

25 patients with severe sepsis and 20 healthy controls.

Measurements and results

Septic patients were randomly assigned to two groups: PMX-F treatment group (n=15) and conventional treatment group (n=10). Total pyridinium crosslink pyridinoline (PYD) and deoxypyridinoline (DPD) in urine were determined by modified high-performance liquid chromatography. Nitric oxide production was assessed by measuring the ratio of the nitric oxide breakdown products to urinary creatinine (NOx/Cr). Plasma endotoxin levels were determined by endospecy test. The blood albumin, ionized calcium, and parathyroid hormone were also measured. PMX-F treatment was performed twice separated by 24 h. Urinary NOx/Cr, PYD/Cr, and DPD/Cr were significantly increased in septic patients compared with those in healthy controls. Blood ionized calcium in septic patients was lower than in healthy controls, while parathyroid hormone levels in septic patients were higher than in healthy controls (P<0.01). PMX-F treatment reduced plasma endotoxin, urinary NOx/Cr, PYD/Cr, DPD/Cr, and serum parathyroid hormone levels and increased blood ionized calcium significantly; however, conventional treatment did not affect these levels.

Conclusions

Septic patients increased nitric oxide production and bone resorption, and PMX-F treatment is effective in reducing nitric oxide levels and bone resorption markers.
Literature
1.
go back to reference Alberti C, Brun-Buissoh C, Burchardi H, Martin C, Goodman S, Artigas A, Sicignaho A, Palazzo M, Moreno R, Boulme R, Lepage E, Le Gall JR (2002) Epidermiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med 28:108–121PubMed Alberti C, Brun-Buissoh C, Burchardi H, Martin C, Goodman S, Artigas A, Sicignaho A, Palazzo M, Moreno R, Boulme R, Lepage E, Le Gall JR (2002) Epidermiology of sepsis and infection in ICU patients from an international multicentre cohort study. Intensive Care Med 28:108–121PubMed
2.
go back to reference Aoki H, Kodama M, Tani T, Hanasawa K (1994) Treatment of sepsis by extracorporeal elimination of endotoxin using polymyxin B-immobilized fiber. Am J Surg 167:412–417CrossRefPubMed Aoki H, Kodama M, Tani T, Hanasawa K (1994) Treatment of sepsis by extracorporeal elimination of endotoxin using polymyxin B-immobilized fiber. Am J Surg 167:412–417CrossRefPubMed
3.
go back to reference Nakamura T, Ebihara I, Shimada N, Koide H (1998) Changes in plasma erythropoietin and interleukin-6 concentrations in patients with septic shock after hemoperfusion with polymyxin B-immobilized fiber. Intensive Care Med 24:1272–1276CrossRefPubMed Nakamura T, Ebihara I, Shimada N, Koide H (1998) Changes in plasma erythropoietin and interleukin-6 concentrations in patients with septic shock after hemoperfusion with polymyxin B-immobilized fiber. Intensive Care Med 24:1272–1276CrossRefPubMed
4.
go back to reference Rosenbrock H, Seifert-Klauss V, Kaspar S, Busch R, Luppa PB (2002) Changes of biochemical bone markers during the menopausal transition. Clin Chem Lab Med 40:143–151PubMed Rosenbrock H, Seifert-Klauss V, Kaspar S, Busch R, Luppa PB (2002) Changes of biochemical bone markers during the menopausal transition. Clin Chem Lab Med 40:143–151PubMed
5.
go back to reference Smith LM, Cuthberton B, Harvie J, Webster N, Robins S, Ralston SH (2002) Increased bone resorption in the critically ill: association with sepsis and increased nitric oxide production. Crit Care Med 30:837–840CrossRefPubMed Smith LM, Cuthberton B, Harvie J, Webster N, Robins S, Ralston SH (2002) Increased bone resorption in the critically ill: association with sepsis and increased nitric oxide production. Crit Care Med 30:837–840CrossRefPubMed
6.
go back to reference American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:964–974 American College of Chest Physicians/Society of Critical Care Medicine Consensus Conference Committee (1992) Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Crit Care Med 20:964–974
7.
go back to reference Nakamura T, Ushiyama C, Suzuki Y, Shoji H, Shimada N, Koide H (2002) Hemoperfusion with polymyxin B immobilized fibers for urinary albumin excretion in septic patients with trauma. ASAIO J 48:244–248CrossRefPubMed Nakamura T, Ushiyama C, Suzuki Y, Shoji H, Shimada N, Koide H (2002) Hemoperfusion with polymyxin B immobilized fibers for urinary albumin excretion in septic patients with trauma. ASAIO J 48:244–248CrossRefPubMed
8.
go back to reference Nakamura T, Ushiyama C, Suzuki Y, Shoji H, Osada S, Shimada N, Koide H (2002) Effect of polymyxin B-immobilized fibre on various mediators in patients with hypothermic sepsis. Clin Intensive Care 12:223–228 Nakamura T, Ushiyama C, Suzuki Y, Shoji H, Osada S, Shimada N, Koide H (2002) Effect of polymyxin B-immobilized fibre on various mediators in patients with hypothermic sepsis. Clin Intensive Care 12:223–228
9.
go back to reference Grabowski PS, England AJ, Dykhuizen R (1996) Elevated nitric oxide production in rheumatoid arthritis. Detection using the fasting urinary nitrate: creatinine ratio. Arthritis Rheum 39:643–647PubMed Grabowski PS, England AJ, Dykhuizen R (1996) Elevated nitric oxide production in rheumatoid arthritis. Detection using the fasting urinary nitrate: creatinine ratio. Arthritis Rheum 39:643–647PubMed
10.
go back to reference Green LC, Wagner DA, Glogowski J, Skipper PL, Wishnok JS, Tannenbaum SR (1982) Analysis of nitrate, nitrite and [15N]nitrate in biological fluids. Anal Biochem 126:131–138PubMed Green LC, Wagner DA, Glogowski J, Skipper PL, Wishnok JS, Tannenbaum SR (1982) Analysis of nitrate, nitrite and [15N]nitrate in biological fluids. Anal Biochem 126:131–138PubMed
11.
go back to reference Robins SP, Black D, Paterson CR, Reid DM, Ducan A, Seibel MJ (1991) Evaluation of urinary hydroxypyridinium crosslink measurements as resorption markers in metabolic bone disease. Eur J Clin Invest 21:310–315PubMed Robins SP, Black D, Paterson CR, Reid DM, Ducan A, Seibel MJ (1991) Evaluation of urinary hydroxypyridinium crosslink measurements as resorption markers in metabolic bone disease. Eur J Clin Invest 21:310–315PubMed
12.
go back to reference Nierman DM, Mechanick JI (1998) Bone hyperresorption is prevalent in chronically critically ill patients. Chest 114:1122–1128PubMed Nierman DM, Mechanick JI (1998) Bone hyperresorption is prevalent in chronically critically ill patients. Chest 114:1122–1128PubMed
13.
go back to reference Moncada S, Higgs A (1993) The L-arginine nitric oxide pathway. N Engl J Med 329:2002–2012PubMed Moncada S, Higgs A (1993) The L-arginine nitric oxide pathway. N Engl J Med 329:2002–2012PubMed
14.
go back to reference Li L, Khansari A, Shapira L, Graves DT, Amar S (2002) Contribution of interleukin-11 and prostaglandin in lipopolysaccharide-induced bone resorption in vivo. Infect Immun 70:3915–3922CrossRefPubMed Li L, Khansari A, Shapira L, Graves DT, Amar S (2002) Contribution of interleukin-11 and prostaglandin in lipopolysaccharide-induced bone resorption in vivo. Infect Immun 70:3915–3922CrossRefPubMed
15.
go back to reference Vassalli P (1992) The pathophysiology of tumor necrosis factors. Annu Rev Immunol 10:411–452PubMed Vassalli P (1992) The pathophysiology of tumor necrosis factors. Annu Rev Immunol 10:411–452PubMed
16.
go back to reference Tani T, Hanasawa K, Kodama M, Imaizumi H, Yonekawa M, Saito M, Ikeda T, Yagi Y, Takayama K, Amano I, Shimaoka H, Ohta M, Okahisa T, Koga N, Fujita N, Yamasa H (2001) Correlation between plasma endotoxin, plasma cytokines, and plasminogen activator inhibitor-1 activities in septic patients. World J Surg 25:660–668CrossRefPubMed Tani T, Hanasawa K, Kodama M, Imaizumi H, Yonekawa M, Saito M, Ikeda T, Yagi Y, Takayama K, Amano I, Shimaoka H, Ohta M, Okahisa T, Koga N, Fujita N, Yamasa H (2001) Correlation between plasma endotoxin, plasma cytokines, and plasminogen activator inhibitor-1 activities in septic patients. World J Surg 25:660–668CrossRefPubMed
17.
go back to reference Jiang Y, Mehta CK, Hsu TY, Alsulaimani FF (2002) Bacteria induce osteoclastogenesis via an osteoblast-independent pathway. Infect Immun 70:3143–3148CrossRefPubMed Jiang Y, Mehta CK, Hsu TY, Alsulaimani FF (2002) Bacteria induce osteoclastogenesis via an osteoblast-independent pathway. Infect Immun 70:3143–3148CrossRefPubMed
18.
go back to reference Lind L, Carlstedt F, Rastad J, Stiernstrom H, Stridsberg M, Ljunggren O, Wide L, Larsson A, Hellman P, Ljunghall S (2000) Hypocalcemia and parathyroid hormone secretion in critically ill patients. Crit Care Med 28:93–99CrossRefPubMed Lind L, Carlstedt F, Rastad J, Stiernstrom H, Stridsberg M, Ljunggren O, Wide L, Larsson A, Hellman P, Ljunghall S (2000) Hypocalcemia and parathyroid hormone secretion in critically ill patients. Crit Care Med 28:93–99CrossRefPubMed
19.
go back to reference Nakamura T, Ebihara I, Shimada N, Shoji H, Koide H (1998) Modulation of plasma metalloproteinase-9 concentrations and peripheral blood monocyte mRNA levels in patients with septic shock. Effect of fiber-immobilized polymyxin B treatment. Am J Med Sci 316:355–360PubMed Nakamura T, Ebihara I, Shimada N, Shoji H, Koide H (1998) Modulation of plasma metalloproteinase-9 concentrations and peripheral blood monocyte mRNA levels in patients with septic shock. Effect of fiber-immobilized polymyxin B treatment. Am J Med Sci 316:355–360PubMed
Metadata
Title
Effect of polymyxin B-immobilized fiber on bone resorption in patients with sepsis
Authors
Tsukasa Nakamura
Yasuhiro Kawagoe
Takaharu Matsuda
Hikaru Koide
Publication date
01-09-2004
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 9/2004
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2357-7

Other articles of this Issue 9/2004

Intensive Care Medicine 9/2004 Go to the issue