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Open Access 01-09-2008 | Original

Polymyxin-B hemoperfusion inactivates circulating proapoptotic factors

Authors: Vincenzo Cantaluppi, Barbara Assenzio, Daniela Pasero, Giuseppe Mauriello Romanazzi, Alfonso Pacitti, Giacomo Lanfranco, Valeria Puntorieri, Erica L. Martin, Luciana Mascia, Gianpaola Monti, Giampaolo Casella, Giuseppe Paolo Segoloni, Giovanni Camussi, V. Marco Ranieri

Published in: Intensive Care Medicine | Issue 9/2008

Abstract

Objective

To test the hypothesis that extracorporeal therapy with polymyxin B (PMX-B) may prevent Gram-negative sepsis-induced acute renal failure (ARF) by reducing the activity of proapoptotic circulating factors.

Setting

Medical-Surgical Intensive Care Units.

Patients and interventions

Sixteen patients with Gram-negative sepsis were randomized to receive standard care (Surviving Sepsis Campaign guidelines) or standard care plus extracorporeal therapy with PMX-B.

Measurements and results

Cell viability, apoptosis, polarity, morphogenesis, and epithelial integrity were evaluated in cultured tubular cells and glomerular podocytes incubated with plasma from patients of both groups. Renal function was evaluated as SOFA and RIFLE scores, proteinuria, and tubular enzymes. A significant decrease of plasma-induced proapoptotic activity was observed after PMX-B treatment on cultured renal cells. SOFA and RIFLE scores, proteinuria, and urine tubular enzymes were all significantly reduced after PMX-B treatment. Loss of plasma-induced polarity and permeability of cell cultures was abrogated with the plasma of patients treated with PMX-B. These results were associated to a preserved expression of molecules crucial for tubular and glomerular functional integrity.

Conclusions

Extracorporeal therapy with PMX-B reduces the proapoptotic activity of the plasma of septic patients on cultured renal cells. These data confirm the role of apoptosis in the development of sepsis-related ARF.

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Title: Polymyxin-B hemoperfusion inactivates circulating proapoptotic factors
Authors: Vincenzo Cantaluppi
Barbara Assenzio
Daniela Pasero
Giuseppe Mauriello Romanazzi
Alfonso Pacitti
Giacomo Lanfranco
Valeria Puntorieri
Erica L. Martin
Luciana Mascia
Gianpaola Monti
Giampaolo Casella
Giuseppe Paolo Segoloni
Giovanni Camussi
V. Marco Ranieri
Publication date: 01-09-2008
Publisher: Springer-Verlag
Published in: Intensive Care Medicine / Issue 9/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-008-1124-6

At a glance: The STEP trials

Springer Medicine

Polymyxin-B hemoperfusion inactivates circulating proapoptotic factors

Abstract

Objective

Setting

Patients and interventions

Measurements and results

Conclusions

At a glance: The STEP trials

Springer Medicine

Abstract

Objective

Setting

Patients and interventions

Measurements and results

Conclusions

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