Document Detail


Angiopoietin balance in septic shock patients treated by direct hemoperfusion with polymyxin b-immobilized fiber.
MedLine Citation:
PMID:  19954476     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Capillary permeability is a tightly regulated feature of microcirculation in all organ beds; however, in sepsis this feature is fundamentally altered. We previously reported elevated levels of vascular endothelial growth factor and its receptor (fms-like tyrosine kinase-1) in patients with septic shock, then investigated two kinds of angiopoietins in those patients. An enzyme-linked immunoassay was used to measure serum angiopoietin-1 and -2 levels in 12 patients with septic shock who were treated by direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX). The angiopoietin-1 level was lower in patients with septic shock (7.01 +/- 10.08 ng/mL) than in controls (28.24 +/- 11.61 ng/mL, P < 0.001), but the angiopoietin-2 level was higher in septic shock patients (40.83 +/- 30.13 ng/mL vs. 2.47 +/- 1.78 ng/mL, P < 0.001). Between seven survivors and five non-survivors there was no significant difference in angiopoietin-1 levels before DHP-PMX therapy. During DHP-PMX therapy, however, the angiopoietin-2 level was significantly decreased in survivors (31.52 +/- 26.15 ng/mL vs. 17.32 +/- 22.46 ng/mL, P = 0.035). Moreover, at the end of the therapy, the angiopoietin-1 level was significantly lower in non-survivors (1.14 +/- 1.30 ng/mL vs. 10.43 +/- 13.56 ng/mL, P = 0.042), but the angiopoietin-2 level in non-survivors was significantly higher (70.79 +/- 40.47 ng/mL vs. 17.32 +/- 22.46 ng/mL, P = 0.019). The angiopoietin-2 level may be associated with vascular permeability in septic patients, and angiopoietins may be suitable markers of disease severity and mortality.
Authors:
Itaru Ebihara; Kouichi Hirayama; Kei Nagai; Tomoko Kakita; Yasunori Miyamoto; Miho Nagai; Yujiro Ogawa; Shogo Fujita; Homare Shimohata; Hirayasu Kai; Joichi Usui; Kunihiro Yamagata; Masaki Kobayashi
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Therapeutic apheresis and dialysis : official peer-reviewed journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy     Volume:  13     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-03     Completed Date:  2010-02-23     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  520-7     Citation Subset:  IM    
Affiliation:
Department of Nephrology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan. itaruebi@yahoo.co.jp
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Angiopoietin-1 / blood*
Angiopoietin-2 / blood*
Biological Markers / blood
Capillary Permeability
Case-Control Studies
Enzyme-Linked Immunosorbent Assay
Female
Hemoperfusion / methods*
Humans
Male
Middle Aged
Polymyxin B / chemistry
Severity of Illness Index
Shock, Septic / mortality,  physiopathology,  therapy*
Survivors
Chemical
Reg. No./Substance:
0/ANGPT1 protein, human; 0/Angiopoietin-1; 0/Angiopoietin-2; 0/Biological Markers; 1404-26-8/Polymyxin B

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