Document Detail

Removal of 2-arachidonylglycerol by direct hemoperfusion therapy with polymyxin B immobilized fibers benefits patients with septic shock.
MedLine Citation:
PMID:  18937720     Owner:  NLM     Status:  MEDLINE    
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.
Yoichi Kase; Toru Obata; Yasuhisa Okamoto; Kenichi Iwai; Keita Saito; Keitaro Yokoyama; Masanori Takinami; Yasumasa Tanifuji
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
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:  12     ISSN:  1744-9987     ISO Abbreviation:  Ther Apher Dial     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-10-21     Completed Date:  2009-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101181252     Medline TA:  Ther Apher Dial     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  374-80     Citation Subset:  IM    
Department of Anesthesiology and Intensive Care Medicine, Jikei University School of Medicine, Tokyo, Japan.
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MeSH Terms
Arachidonic Acids / blood*
Case-Control Studies
Endotoxins / blood*
Follow-Up Studies
Hemoperfusion / methods*
Middle Aged
Polymyxin B / therapeutic use*
Polyunsaturated Alkamides / blood*
Prospective Studies
Reference Values
Risk Assessment
Sensitivity and Specificity
Severity of Illness Index
Shock, Septic / blood,  mortality,  physiopathology,  therapy*
Survival Rate
Treatment Outcome
Reg. No./Substance:
0/Arachidonic Acids; 0/Endotoxins; 0/Polyunsaturated Alkamides; 1404-26-8/Polymyxin B; 94421-68-8/anandamide

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