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Published on: June 15, 2019
Hemofiltration and immune response in severe sepsis
Christian Hörner1, Silke Schuster, Jens Plachky
1Department of Anesthesia, University of Heidelberg, Heidelberg, Germany. christian.hoerner@med.uni-heidelberg.de
The Journal of Surgical Research
|August 25, 2007
Summary
Septic patient plasma increases immune cell adhesion molecule expression and suppresses cytokine production. Continuous venovenous hemofiltration (CVVH) effectively removes these immune-modulating substances from plasma.
Area of Science:
- Immunology
- Critical Care Medicine
- Nephrology
Background:
- Measuring individual cytokines is insufficient to determine the overall immune status.
- Assessing functional immune responses provides a more comprehensive understanding of patient conditions.
- Investigating immune function in plasma and continuous venovenous hemofiltration (CVVH) ultrafiltrate is crucial for critically ill patients.
Purpose of the Study:
- To determine the resulting immune functions in the plasma of septic and critically ill patients.
- To analyze immune responses in ultrafiltrate obtained from CVVH.
- To evaluate the impact of septic plasma on leukocyte activation and cytokine secretion.
Main Methods:
- Studied nine septic and six critically ill patients with renal dysfunction over 72 hours.
- Assessed plasma-induced beta(2)-integrin expression on neutrophils as a marker of leukocyte activation.
- Measured Interleukin (IL)-6 and IL-10 production/inhibition in whole blood cells stimulated by patient plasma.
Main Results:
- Plasma from septic patients consistently increased beta(2)-integrin expression on neutrophils.
- Septic plasma suppressed IL-6 and IL-10 production in stimulated whole blood.
- CVVH ultrafiltrate mirrored plasma immune response patterns, with no significant changes pre- or post-filter.
Conclusions:
- Septic patient plasma enhances adhesion molecule expression and inhibits IL-6/IL-10 secretion compared to non-septic patients.
- CVVH effectively removes bioactive immune-modulating mediators from plasma.
- Immune function analysis offers a better assessment of patient immune status than isolated cytokine measurements.
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