| Biological and Technical Considerations Regarding the Removal of Bacteriotoxins in Sepsis with Emphasis on Tsst-1. | |
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MedLine Citation:
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PMID: 22129566 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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ABSTRACT: Severe sepsis is characterized by rapid development of multiple organ failure associated with high mortality. Bacterial toxin release triggers a sequence of events that activates intracellular pathways to produce inflammatory mediators and nitric oxide. There have been numerous attempts to interrupt this devastating cascade by removing toxins, removing or inhibiting mediators, and by blocking receptors of mediators. This review considers toxin properties with a strong focus on Toxic Shock Syndrome Toxin-1, TSST-1, and the potential of various removal technologies in relation to these properties. The distribution of toxins in vivo form a key issue, nevertheless, are poorly defined. For TSST-1, either a high clearance or a high degree of compartmentalization to a space not accessible by pheresis or immuno-absorption technologies seems likely. Attempts to remove toxins to treat sepsis may appear futile if we cannot access this space or when the level of induced clearance is too low compared to natural clearance. The impact of these considerations is highly dependent on the exact toxin biology in vivo. Extrapolated to other toxins, we indicate a set of general requirements to be met in order to facilitate successful toxin removal by a pheresis technique. |
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Authors:
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Walter J Brummelhuis; Jaap A Joles; Jord Stam; C Theo Verrips; Branko Braam |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-11-29 |
Journal Detail:
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Title: Shock (Augusta, Ga.) Volume: - ISSN: 1540-0514 ISO Abbreviation: - Publication Date: 2011 Nov |
Date Detail:
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Created Date: 2011-12-1 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9421564 Medline TA: Shock Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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1 Department of Nephrology and Hypertension, Univ. Medical Center Utrecht, The Netherlands. 2 Cellular Architecture & Dynamics, Department Biology, University Utrecht, The Netherlands. 3 Division of Nephrology and Immunology, Department of Medicine, University of Alberta Hospital, Edmonton, Canada. 4Department of Physiology, University of Alberta, Edmonton, Canada. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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