| Removal of 2-arachidonylglycerol by direct hemoperfusion therapy with polymyxin B immobilized fibers benefits patients with septic shock. | |
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MedLine Citation:
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PMID: 18937720 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Arachidonylethanolamide (AEA) and 2-arachidonylglycerol (2-AG) are endocannabinoids involved in septic shock, and 8-epi prostaglandin F2alpha (F2-isoprostane) is a biomarker of oxidative stress in biological systems. Because the antibiotic polymyxin B absorbs endocannabinoids as well as endotoxins, direct hemoperfusion therapy with polymyxin B-immobilized fibers (PMX-DHP) decreases serum levels of endocannabinoids. To investigate the features of sepsis and determine the proper use of PMX-DHP, we measured the changes in levels of endocannabinoids and F2-isoprostane in patients with septic shock. Twenty-six patients with septic shock, including those with septic shock induced by peritonitis, underwent laparotomy for drainage. Endocannabinoids absorption with PMX-DHP was examined in two groups of patients: patients whose mean arterial blood pressure (mABP) had increased more than 20 mm Hg (responder group; N = 13); and patients iwhose mABP did not increase or had increased no more than 20 mm Hg (non-responder group; N = 13). Levels of AEA did not change after PMX-DHP in either the non-responder or responder groups, whereas levels of 2-AG decreased significantly after PMX-DHP in the responder group, but not in the non-responder group. F2-isoprostane gradually increased after PMX-DHP treatment; on the other hand, levels of F2-isoprostane remained constant in the responder group. Patients with septic shock are under considerable oxidative stress, and 2-AG plays an important role in the cardiovascular status of these patients. The removal of 2-AG by PMX-DHP benefits patients with septic shock by stabilizing cardiovascular status and decreasing long-term oxidative stress. |
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Authors:
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Yoichi Kase; Toru Obata; Yasuhisa Okamoto; Kenichi Iwai; Keita Saito; Keitaro Yokoyama; Masanori Takinami; Yasumasa Tanifuji |
Publication Detail:
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Type: Comparative Study; Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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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: 12 ISSN: 1744-9987 ISO Abbreviation: Ther Apher Dial Publication Date: 2008 Oct |
Date Detail:
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Created Date: 2008-10-21 Completed Date: 2009-01-07 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101181252 Medline TA: Ther Apher Dial Country: Australia |
Other Details:
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Languages: eng Pagination: 374-80 Citation Subset: IM |
Affiliation:
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Department of Anesthesiology and Intensive Care Medicine, Jikei University School of Medicine, Tokyo, Japan. y.kase@jikei.ac.jp |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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APACHE Aged Arachidonic Acids / blood* Case-Control Studies Endotoxins / blood* Female Follow-Up Studies Hemoperfusion / methods* Humans Male Middle Aged Polymyxin B / therapeutic use* Polyunsaturated Alkamides / blood* Probability Prospective Studies Reference Values Risk Assessment Sensitivity and Specificity Severity of Illness Index Shock, Septic / blood, mortality, physiopathology, therapy* Survival Rate Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Arachidonic Acids; 0/Endotoxins; 0/Polyunsaturated Alkamides; 1404-26-8/Polymyxin B; 94421-68-8/anandamide |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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