Hemoadsorption corrects hyperresistinemia and restores anti-bacterial neutrophil function

Area of Science:

• Immunology
• Critical Care Medicine
• Nephrology

Background:

• Sepsis involves immune activation and suppression, with resistin, an inflammatory cytokine, playing a key role.
• Septic hyperresistinemia (elevated plasma resistin) worsens sepsis severity and outcomes, particularly with acute kidney injury (AKI).
• Elevated resistin impairs neutrophil function, including migration, hindering the initial defense against bacterial infections.

Purpose of the Study:

• To investigate the impact of hyperresistinemia on neutrophil-mediated bacterial clearance and reactive oxygen species (ROS) generation.
• To evaluate the efficacy of hemoadsorption in correcting hyperresistinemia and associated neutrophil dysfunction.

Main Methods:

• Analyzed serum resistin levels and neutrophil migration in 13 septic shock patients and 6 controls.
• In vitro experiments measured bacterial clearance and ROS generation in neutrophils exposed to hyperresistinemia.
• Assessed hemoadsorption using Amberchrome™ (AC) and CytoSorb® (CC) for resistin reduction and restoration of neutrophil function.

Main Results:

• Septic shock patients exhibited higher resistin levels, correlating with reduced neutrophil migration.
• Hyperresistinemia significantly impaired intracellular bacterial clearance and dose-dependently reduced ROS production.
• Hemoadsorption with AC and CC successfully reduced resistin levels and restored neutrophil migration, ROS generation, and bacterial clearance.

Conclusions:

• Septic hyperresistinemia inhibits neutrophil migration, bacterial clearance, and ROS generation.
• This neutrophil dysfunction is reversible with hemoadsorption therapy.
• Hemoadsorption offers a promising therapeutic strategy to improve neutrophil function and mitigate immunosuppression in sepsis.