Abstract
BackgroundBlood purification is an emerging approach to dampening the cytokine storm. This study aims to assess the efficacy of HA330 resin-directed hemoadsorption (HA) on endotoxin-induced porcine acute respiratory distress syndrome (ARDS) model.MethodsTwenty-four Chinese domestic pigs were allocated into saline group receiving intravenous infusion of saline (N = 6) and endotoxin group receiving intravenous infusion of LPS (N = 18). When ALI model was initially diagnosed, six pigs in the LPS and saline group were killed for BALF and histopathological analysis. The remaining 12 pigs in LPS group received 3-h HA (N = 6) or HA-sham (N = 6) treatment, respectively. Following another 5-h observation, animals were killed. Variables on hemodynamics, blood gases and lung mechanics were recorded at a series of time points. Differentially expressed cytokines and proteins were determined by ELISA and proteomics.ResultsHA treatment significantly improved injured oxygenation induced by LPS. HA also partially improved the barrier permeability and reduced lung edema and inflammation/injury induced by LPS infusion. Proteomic analysis showed the differentially expressed proteins between HA- and HA-sham-treated groups mostly belonged to the categories of acute inflammation/immune response, and proteolysis.ConclusionsHemoadsorption improved ARDS possibly by blunting the cytokine storm and by restoring homeostasis of the disordered proteome milieu in the exudative phase.
Highlights
Blood purification is an emerging approach to dampening the cytokine storm
The changes did not reach statistical difference when compared with saline group
Low dosage of LPS can induce significant acute respiratory distress syndrome (ARDS)-like features in these animals. Animals such as rodents or dogs require much higher doses to develop lung injury. This different vulnerability to LPS may be induced by the pulmonary intravascular macrophages (PIM), a lung resident population of mature macrophage [19]. 8–100 μg/ kg of LPS has been used in several previous studies to develop porcine ARDS model [12, 20, 21]
Summary
This study aims to assess the efficacy of HA330 resin-directed hemoadsorption (HA) on endotoxin-induced porcine acute respiratory distress syndrome (ARDS) model. The acute respiratory distress syndrome (ARDS) is a condition with the acute onset of noncardiac respiratory failure that develops in response to a series of insults to the alveolar-capillary barrier [1]. The current mainstay therapy for ARDS is largely supportive [2, 3]. This has been shown to reduce mortality by limiting further iatrogenic injury to the already injured lungs. There are only some inconsistent preliminary data to investigate the effects of hemofiltration (a modality of EBP) on ARDS animal models [8, 9]. It has been shown that hemoadsorption (HA), another modality of EBP, can improve oxygenation in septic patients
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