Extracorporeal therapy of sepsis by purified granulocyte concentrates: ex vivo circulation model

Gerd Klinkmann; Thomas Wild; Benjamin HeskampFanny DossSandra DossMagdalena MilejLea‐Marie ThieleLilia GoudevaRainer BlasczykDaniel A. ReuterJens AltrichterSteffen Mitzner

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Extracorporeal therapy of sepsis by purified granulocyte concentrates: ex vivo circulation model

机译：Extracorporeal therapy of sepsis by purified granulocyte concentrates: ex vivo circulation model

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Abstract Background Immune cell dysfunction is a central part of immune paralysis in sepsis. Granulocyte concentrate (GC) transfusions can induce tissue damage via local effects of neutrophils. The hypothesis of an extracorporeal plasma treatment with granulocytes is to show beneficial effects with fewer side effects. Clinical trials with standard GC have supported this approach. This ex vivo study investigated the functional properties of purified granulocyte preparations during the extracorporeal plasma treatment. Methods Purified GC were stored for up to 3?days and compared with standard GC in an immune cell perfusion therapy model. The therapy consists of a plasma separation device and an extracorporeal circuit. Plasma is perfused through the tubing system with donor immune cells of the GC, and only the treated plasma is filtered for re‐transfusion. The donor immune cells are retained in the extracorporeal system and discarded after treatment. Efficacy of granulocytes regarding phagocytosis,?oxidative?burst as well as cell viability and metabolic parameters were assessed. Results In pGC, the metabolic surrogate parameters of cell functionality showed comparable courses even after a storage period of 72?h. In particular, glucose and oxygen consumption were lower after extended storage. The course of?lactate dehydrogenase concentration yields no indication of cell impairment in the extracorporeal circulation. The cells were viable throughout the entire study period and exhibited preserved phagocytosis and oxidative?burst functionality. Conclusion The granulocytes demonstrated full functionality in the 6?h extracorporeal circuits after 3?days storage and in septic shock plasma. This is demonstrating the functionality of the system and encourages further clinical studies.

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《Artificial Organs》 |2023年第7期|1151-1162|共12页
作者
Gerd Klinkmann; Thomas Wild; Benjamin HeskampFanny DossSandra DossMagdalena MilejLea‐Marie ThieleLilia GoudevaRainer BlasczykDaniel A. ReuterJens AltrichterSteffen Mitzner;
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作者单位

Department of Anaesthesiology, Intensive Care Medicine and Pain Therapy,University of Rostock;

ARTCLINE GmbH;

Department of Medicine, Division of Nephrology, Medical Faculty,University of RostockInstitute of Transfusion Medicine and Transplant Engineering, Hannover Medical SchoolDepartment of Extracorporeal Immunomodulation,Fraunhofer Institute for Cell Therapy and Immunology;

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正文语种英语
中图分类器官移植术;
关键词
clinical use; extracorporeal therapy; granulocyte concentrate; sepsis;

Extracorporeal therapy of sepsis by purified granulocyte concentrates: ex vivo circulation model

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