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Cytokine modulation with continuous hemodiafiltration for treatment and prevention of multiple organ failure

Research Project

Project/Area Number 11470238
Research Category

Grant-in-Aid for Scientific Research (B)

Allocation TypeSingle-year Grants
Section一般
Research Field General surgery
Research InstitutionChiba University

Principal Investigator

HIRASAWA Hiroyuki  Chiba University, Graduate School of Medicine, Professor, 大学院・医学研究院, 教授 (80114320)

Co-Investigator(Kenkyū-buntansha) NAKANISHI Kazuya  Chiba University, University Hospital, Assistant, 医学部・附属病院, 助手 (80272326)
SHIGA Hidetoshi  Chiba University, University Hospital Lecturer, 医学部・附属病院, 講師 (20282478)
ODA Shigeto  Chiba University, Graduate School of Medicine, Assistant Professor, 医学部, 助教授 (90204205)
NAKAMURA Masataka  Chiba University, University Hospital, Assistant, 医学部・附属病院, 助手 (30315436)
MATSUDA Ken-ichi  Chiba University, University Hospital, Assistant, 医学部・附属病院, 助手 (60282480)
菅井 桂雄  千葉大学, 医学部, 助教授 (10187627)
Project Period (FY) 1999 – 2001
Project Status Completed (Fiscal Year 2001)
Budget Amount *help
¥14,000,000 (Direct Cost: ¥14,000,000)
Fiscal Year 2001: ¥3,100,000 (Direct Cost: ¥3,100,000)
Fiscal Year 2000: ¥3,300,000 (Direct Cost: ¥3,300,000)
Fiscal Year 1999: ¥7,600,000 (Direct Cost: ¥7,600,000)
KeywordsSIRS / multiple organ failure / cytokine / hypercytokinemia / apoptosis / cytokine modulation / apoptosis modulation / アポトーシスモデュレーション
Research Abstract

Inflammatory cytokines have been implicated as a key mediator playing an important role in the pathophysiology of multiple organ failure (MOF). This study was undertaken to evaluate the removal of cytokines from the circulation with continuous hemodiafiltration (CHDF) using polymethyl methacrylate membrane (PMMA-CHDF) and the efficacy of PMMA-CHDF in the treatment of sepsis or other critical conditions through such removal of causative mediators. In this study, we found that clearance of cytokines with PMMA-CHDF positively correlates with pre-CHDF blood levels of cytokine : the higher the blood level, the greater the clearance. Furthermore, our data showed that the blood levels of cytokines were significantly decreased with PMMA-CHDF. As for the clinical benefits of cytokine removal, there were positive correlation between changes in blood levels of cytokines with PMMA-CHDF and changes in cellular injury score in MOF patients. In acute respiratory distress syndrome (ARDS), there was a significant and positive correlation between the degree of decrease in blood levels of cytokines and the degree of improvement in respiratory index (RI). Thus these data clearly demonstrated that cytokine removal with PMMA-CHDF was clinically relevant in the critically ill. On the other hand, spontaneous and cytokine-induced apoptosis of circulating polymorphonuclear leukocyte (PMN) wewe greatly decreased in critical conditions such as sepsis and MOF. In contrast, the inhibited circulating PMN apoptosis could lead to be amplified systemic inflammation and organ injury. Therefore, we evaluated whether the removal of cytokines with PMMA-CHDF can modulates circulating PMN apoptosis or not. We investigated the relation between blood levels of cytokines and circulating PMN apoptosis with PMMA-CHDF in organ failure patients. We found that there was a correlation between the degree of decrease in blood levels of interleukin-6 and the degree of improvement in circulating PMN apoptosis.

Report

(4 results)
  • 2001 Annual Research Report   Final Research Report Summary
  • 2000 Annual Research Report
  • 1999 Annual Research Report
  • Research Products

    (17 results)

All Other

All Publications (17 results)

  • [Publications] 平澤 博之: "Endotoxin adsorption or hemodiafiltration in the treatment of multiple organ failure"Current Opinion in Critical Care. 6. 421-425 (2000)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 平澤 博之: "持続的血液濾過透析を用いた重症急性膵炎の治療"肝胆膵. 42・6. 723-734 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 松田 兼一: "多臓器不全と血液浄化法"lCUとCCU. 25・8. 573-583 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 松田 兼一: "Cardiogenic shockとseptic shockに対する持続的血液濾過透析(CHDF)による組織酸素代謝改善の機序の相違"ICUとCCU. 25・8. 603-605 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 松田 兼一: "Current topics in cytokine removal technologies"Therapeutic Apheresis. 5・4. 306-314 (2001)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 織田 成人: "サイトカイン除去技術の最近の動向"日本アフェレシス学会雑誌. 21・1. 47-53 (2002)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Hirasawa H, Oda S, Shiga H, et al.: "Endotosin adsorption or hemodiafiltration in the treatment of multiple organ failure"Current Opinion Critical Care. 6. 421-425 (2000)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Hirasawa H, Qda S, Shiga H, et al.: "Continuous hemodiafiltration in the treatment of severe acute pancreatitis"KAN・TAN・SUI. 423-734 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Matsuda K, Hirasawa H, Oda S, et al.: "Blood Purification in the Treatment of Multiple Organ Failure (MOF)"Japanese Journal of Intensive Care Medicine. 25. 573-583 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Matsuda K, Hirasawa H, Oda S, et al.: "Current topics on cytokine removal technologies"Therapeutic Apheresis. 5. 306-314 (2001)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] Oda S, Hirasawa H, Shiga H, et al.: "Recent Progress in Technique for Cytokine Removal with Blood Purification"Japanese Journal of Apheresis. 21. 47-53 (2002)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      2001 Final Research Report Summary
  • [Publications] 平澤 博之: "Endotoxin adsorption or hemodiafiltration in the treatment of multiple organ failure"Current Opinion in Critical Care. 6. 421-425 (2000)

    • Related Report
      2001 Annual Research Report
  • [Publications] 平澤 博之: "持続的血液濾過透析を用いた重症急性膵炎の治療"肝胆膵. 42・6. 723-734 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 松田 兼一: "多臓器不全と血液浄化法"ICUとCCU. 25・8. 573-583 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 松田 兼一: "Cardiogenic shockとseptic shockに対する持続的血液濾過透析(CHDF)による組織酸素代謝改善の機序の相違"ICUとCCU. 25・8. 603-605 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 松田 兼一: "Current topics in cytokine removal technologies"Therapeutic Apheresis. 5・4. 306-314 (2001)

    • Related Report
      2001 Annual Research Report
  • [Publications] 織田 成人: "サイトカイン除去技術の最近の動向"日本アフェレシス学会雑誌. 21・1. 47-53 (2002)

    • Related Report
      2001 Annual Research Report

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Published: 1999-04-01   Modified: 2016-04-21  

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