2024 Fiscal Year Final Research Report

Elucidation of the fever mechanism and establishment of fever prevention in cell-free and concentrated ascites reinfusion therapy

Research Project

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Project/Area Number	22K12766
Research Category	Grant-in-Aid for Scientific Research (C)
Allocation Type	Multi-year Fund
Section	一般
Review Section	Basic Section 90110:Biomedical engineering-related
Research Institution	The University of Tokushima
Principal Investigator	OKAHISA Toshiya 徳島大学, 大学院医歯薬学研究部(医学域), 特任教授 (60304515)
Co-Investigator(Kenkyū-buntansha)	曽我部正弘徳島大学, キャンパスライフ健康支援センター, 教授 (60732790) 獅々堀正幹徳島大学, 大学院社会産業理工学研究部(理工学域), 教授 (50274262) 中川忠彦島根県立大学, 看護栄養学部, 講師 (40634275)
Project Period (FY)	2022-04-01 – 2025-03-31
Keywords	腹水濾過濃縮再静注法 / 処理流量 / 発熱 / サイトカイン
Outline of Final Research Achievements	From the results of clinical evaluation and simulated ascites experiments, it is believed that a certain percentage of cytokines are removed into the wastewater by ascites processing during CART, and that the flow rate does not affect the cytokine concentration and total amount in the processed ascites, nor fever. However, it is highly likely that the processed ascites contains a large amount of cytokines that cause fever, and the reinfusion rate is also a fever-related factor. To prevent blood pressure drops and renal damage during ascites processing and fever during reinfusion, it is necessary to shorten the processing time by high-flow processing and to actively administer prophylactic steroids, and it is considered preferable to reinfuse the recovered fluid at a slower rate. From now on, it will be necessary to optimize the setting conditions for shortening the processing time, the prophylactic administration of steroids, and the reinfusion rate.
Free Research Field	消化器内科
Academic Significance and Societal Importance of the Research Achievements	CARTは、様々な進行癌治療を行う際の全身状態を整える治療法として重要な位置を占めるようになってきた。また、遺伝子パネル検査や癌ワクチンへの応用など、今後の癌個別化療法への応用も期待されている。今回の研究によって、CART時の発熱予防目的に推奨されてきた腹水の低流量処理と、迅速な処理を可能とする高流量処理との間で、サイトカインの観点から発熱リスクに差がない事が明らかとなった。今後の多量の癌性腹水に対するCARTを安全に施行するために、高流量処理による処理時間短縮と積極的なステロイドの予防投与が必要で、回収液の点滴再静注速度は遅い方が望ましいことが明確となった点で学術的・社会的意義は大きい。