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- Title
Angiopoietin Balance in Septic Shock Patients Treated by Direct Hemoperfusion With Polymyxin B-immobilized Fiber.
- Authors
Ebihara, Itaru; Hirayama, Kouichi; Nagai, Kei; Kakita, Tomoko; Miyamoto, Yasunori; Nagai, Miho; Ogawa, Yujiro; Fujita, Shogo; Shimohata, Homare; Kai, Hirayasu; Usui, Joichi; Yamagata, Kunihiro; Kobayashi, Masaki
- Abstract
Capillary permeability is a tightly regulated feature of microcirculation in all organ beds; however, in sepsis this feature is fundamentally altered. We previously reported elevated levels of vascular endothelial growth factor and its receptor ( fms-like tyrosine kinase-1) in patients with septic shock, then investigated two kinds of angiopoietins in those patients. An enzyme-linked immunoassay was used to measure serum angiopoietin-1 and -2 levels in 12 patients with septic shock who were treated by direct hemoperfusion with a polymyxin B-immobilized fiber column (DHP-PMX). The angiopoietin-1 level was lower in patients with septic shock (7.01 ± 10.08 ng/mL) than in controls (28.24 ± 11.61 ng/mL, P < 0.001), but the angiopoietin-2 level was higher in septic shock patients (40.83 ± 30.13 ng/mL vs. 2.47 ± 1.78 ng/mL, P < 0.001). Between seven survivors and five non-survivors there was no significant difference in angiopoietin-1 levels before DHP-PMX therapy. During DHP-PMX therapy, however, the angiopoietin-2 level was significantly decreased in survivors (31.52 ± 26.15 ng/mL vs. 17.32 ± 22.46 ng/mL, P = 0.035). Moreover, at the end of the therapy, the angiopoietin-1 level was significantly lower in non-survivors (1.14 ± 1.30 ng/mL vs. 10.43 ± 13.56 ng/mL, P = 0.042), but the angiopoietin-2 level in non-survivors was significantly higher (70.79 ± 40.47 ng/mL vs. 17.32 ± 22.46 ng/mL, P = 0.019). The angiopoietin-2 level may be associated with vascular permeability in septic patients, and angiopoietins may be suitable markers of disease severity and mortality.
- Publication
Therapeutic Apheresis & Dialysis, 2009, Vol 13, Issue 6, p520
- ISSN
1744-9979
- Publication type
Article
- DOI
10.1111/j.1744-9987.2009.00777.x