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Yue Z, Xiaoli G, Juan Z, Qun W, Feng W, Yongke Z. Effect of the oxygenic groups on activated carbon on its hemocompatibility. Colloids Surf B Biointerfaces 2024; 233:113655. [PMID: 37988821 DOI: 10.1016/j.colsurfb.2023.113655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Revised: 11/03/2023] [Accepted: 11/13/2023] [Indexed: 11/23/2023]
Abstract
In this research, the effect of the oxygenic groups on activated carbon on its hemocompatibility was studied by liquid-phase oxidation to introduce oxygenic groups on its surface and subsequent heat treatment under a nitrogen environment to remove these groups. Hemocompatibility was assessed through coagulation, hemolysis, platelet adhesion, and protein adsorption using rabbit blood samples. Results showed that an increasing presence of oxygenic groups improved hemocompatibility, evidenced by enhanced coagulation, reduced hemolysis, better platelet adhesion, and decreased fetal bovine serum protein adsorption. Conversely, the removal of oxygenic groups diminished hemocompatibility, except for coagulation when groups were removed at 250 ℃ for 15 min. Therefore, this research presents a promising route to enhance the hemocompatibility of activated carbon, offering insights into surface modification for improved biomaterial design.
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Affiliation(s)
- Zhong Yue
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563099, China
| | - Ge Xiaoli
- Pharmacy school of Zunyi Medical University, Zunyi 563099, China
| | - Zhang Juan
- Pharmacy school of Zunyi Medical University, Zunyi 563099, China
| | - Wei Qun
- Pharmacy school of Zunyi Medical University, Zunyi 563099, China
| | - Wang Feng
- The Second Affiliated Hospital of Zunyi Medical University, Zunyi 563099, China.
| | - Zhong Yongke
- Pharmacy school of Zunyi Medical University, Zunyi 563099, China.
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Mikaeili H, Taghizadieh A, Nazemiyeh M, Rezaeifar P, Zununi Vahed S, Safiri S, Ardalan M, Ansarin K. The early start of hemoperfusion decreases the mortality rate among severe COVID-19 patients: A preliminary study. Hemodial Int 2021; 26:176-182. [PMID: 34907633 DOI: 10.1111/hdi.12982] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Revised: 08/11/2021] [Accepted: 11/30/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Coronavirus disease-2019 (COVID-19)-related organ failure is partly related to a sepsis-like syndrome and extreme pro-inflammatory cytokine release, named cytokine storm. Therapeutic strategies that prevent the production of or remove the pro-inflammatory cytokines could potentially be an effective therapy in critically afflicted COVID-19 patients. METHODS In this clinical trial study, from April until June 2020, 68 COVID-19 patients (35 vs. 33 controls) with severe critical symptoms, and PaO2 /FiO2 (P/F) ratio less than 200 mmHg either received a single standard therapy or a combination of standard treatment for COVID-19 combined with hemoperfusion (hemofilter, HA330 D Javfron) for 4 h, in 3 consecutive days. The length of hospital stay and mechanical ventilation, the resolution of radiologic abnormalities, and the mortality rate were defined as the primary outcomes. RESULTS Demographic characteristics, the acute physiology, and chronic health evaluation score of both groups were similar (p > 0.05). Importantly, we noticed a significant mortality rate reduction in the perfused group compared with controls (37.1% vs. 63.6%, p = 0.02), this positive effect was stronger among those with a P/F ratio higher than 75 (mortality rate of 84.7% for P/F ratio < 75 vs. 15.4% for P/F ratio ≥ 75, p = 0.02). CONCLUSIONS The results imply that early start of hemoperfusion could be more effective and significantly reduce the mortality rate among COVID-19 patients with critical diseases.
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Affiliation(s)
- Haleh Mikaeili
- Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Ali Taghizadieh
- Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Masoud Nazemiyeh
- Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Parisa Rezaeifar
- Tuberculosis and Lung Disease Research Center, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Saeid Safiri
- Department of Community Medicine, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran
| | | | - Khalil Ansarin
- Rahat Breath and Sleep Research Center, Tabriz University of Medical Sciences, Tabriz, Iran
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Tampe D, Korsten P, Bremer SCB, Winkler MS, Tampe B. Kinetics of Bilirubin and Ammonia Elimination during Hemadsorption Therapy in Secondary Sclerosing Cholangitis Following ECMO Therapy and Severe COVID-19. Biomedicines 2021; 9:biomedicines9121841. [PMID: 34944657 PMCID: PMC8698542 DOI: 10.3390/biomedicines9121841] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 12/03/2021] [Accepted: 12/04/2021] [Indexed: 12/14/2022] Open
Abstract
In critically ill patients, liver dysfunction often results in coagulopathy and encephalopathy and is associated with high mortality. Extracorporeal clearance of hepatotoxic metabolites, including bilirubin and ammonia, aims to attenuate further hepatocyte damage and liver injury, resulting in decreased mortality. The efficacy of hemadsorption combined with conventional hemodialysis to eliminate bilirubin and ammonia to support the liver's excretory function in acute liver injury has been described previously. However, the optimal use of liver support systems in chronic liver dysfunction due to secondary sclerosing cholangitis in critically ill patients (SSC-CIP) has not been defined yet. We herein describe the kinetics of successful bilirubin and ammonia elimination by hemadsorption in a patient with SSC-CIP after extracorporeal membrane oxygenation (ECMO) therapy for severe acute respiratory distress syndrome (ARDS) in a patient with coronavirus disease 2019 (COVID-19). During the course of the disease, the patient developed laboratory signs of liver injury during ECMO therapy before clinically detectable jaundice or elevated bilirubin levels. A diagnosis of SSC-CIP was confirmed by endoscopic retrograde cholangiopancreatography (ERCP) based on intraductal filling defects in the intrahepatic bile ducts due to biliary casts. The patient showed stable elevations of bilirubin and ammonia levels thereafter, but presented with progressive nausea, vomiting, weakness, and exhaustion. Based on these laboratory findings, hemadsorption was combined with hemodialysis treatment and successfully eliminated bilirubin and ammonia. Moreover, direct comparison revealed that ammonia is more efficiently eliminated by hemadsorption than bilirubin levels. Clinical symptoms of nausea, vomiting, weakness, and exhaustion improved. In summary, bilirubin and ammonia were successfully eliminated by hemadsorption combined with hemodialysis treatment in SSC-CIP following ECMO therapy and severe COVID-19. This observation is particularly relevant since it has been reported that a considerable subset of critically ill patients with COVID-19 suffer from liver dysfunction associated with high mortality.
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Affiliation(s)
- Désirée Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, 37075 Göttingen, Germany; (D.T.); (P.K.)
| | - Peter Korsten
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, 37075 Göttingen, Germany; (D.T.); (P.K.)
| | - Sebastian C. B. Bremer
- Department of Gastroenterology, Gastrointestinal Oncology and Endocrinology, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Martin S. Winkler
- Department of Anesthesiology, Emergency and Intensive Care Medicine, University Medical Center Göttingen, 37075 Göttingen, Germany;
| | - Björn Tampe
- Department of Nephrology and Rheumatology, University Medical Center Göttingen, 37075 Göttingen, Germany; (D.T.); (P.K.)
- Correspondence: ; Tel.: +49-551-39-10575
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4
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Magnani S, Atti M. Uremic Toxins and Blood Purification: A Review of Current Evidence and Future Perspectives. Toxins (Basel) 2021; 13:toxins13040246. [PMID: 33808345 PMCID: PMC8066023 DOI: 10.3390/toxins13040246] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 03/25/2021] [Accepted: 03/26/2021] [Indexed: 12/15/2022] Open
Abstract
Accumulation of uremic toxins represents one of the major contributors to the rapid progression of chronic kidney disease (CKD), especially in patients with end-stage renal disease that are undergoing dialysis treatment. In particular, protein-bound uremic toxins (PBUTs) seem to have an important key pathophysiologic role in CKD, inducing various cardiovascular complications. The removal of uremic toxins from the blood with dialytic techniques represents a proved approach to limit the CKD-related complications. However, conventional dialysis mainly focuses on the removal of water-soluble compounds of low and middle molecular weight, whereas PBTUs are strongly protein-bound, thus not efficiently eliminated. Therefore, over the years, dialysis techniques have been adapted by improving membranes structures or using combined strategies to maximize PBTUs removal and eventually prevent CKD-related complications. Recent findings showed that adsorption-based extracorporeal techniques, in addition to conventional dialysis treatment, may effectively adsorb a significant amount of PBTUs during the course of the sessions. This review is focused on the analysis of the current state of the art for blood purification strategies in order to highlight their potentialities and limits and identify the most feasible solution to improve toxins removal effectiveness, exploring possible future strategies and applications, such as the study of a synergic approach by reducing PBTUs production and increasing their blood clearance.
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5
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Moradi H, Abbasi S. Hemoperfusion as a Supportive Treatment in a COVID-19 Patient with Late Pulmonary Thromboembolism: A Case Report. Int Med Case Rep J 2020; 13:341-345. [PMID: 32821175 PMCID: PMC7423352 DOI: 10.2147/imcrj.s263127] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 07/17/2020] [Indexed: 12/20/2022] Open
Abstract
In late 2019, the world encountered an unexpected new virus, resulting in a highly challenging new pandemic. The case presented here involves a 73-year-old man experiencing fever and respiratory distress, who was ultimately diagnosed with COVID-19. During the course of his hospitalization, the patient developed acute respiratory distress syndrome (ARDS), followed by being intubated due to his breathing difficulties. Because of variations in the patient’s clinical features, we decided to perform hemoperfusion to remove cytokines. Afterward, his clinical status improved significantly, and he was discharged in stable condition. However, 26 days later, fever and respiratory distress manifested again. After evaluation, pulmonary thromboembolism was confirmed through computed tomography (ie, CT scan).
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Affiliation(s)
- Hazhir Moradi
- Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Saeed Abbasi
- Anesthesiology and Critical Care Research Center, Isfahan, Iran.,Nosocomial Infection Research Center, Isfahan, Iran.,Anesthesiology and Critical Care Department, Isfahan University of Medical Sciences, Isfahan, Iran
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Geremia I, Pavlenko D, Maksymow K, Rüth M, Lemke HD, Stamatialis D. Ex vivo evaluation of the blood compatibility of mixed matrix haemodialysis membranes. Acta Biomater 2020; 111:118-128. [PMID: 32447066 DOI: 10.1016/j.actbio.2020.05.016] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2020] [Revised: 04/16/2020] [Accepted: 05/13/2020] [Indexed: 02/07/2023]
Abstract
The patients with end stage kidney disease need haemodialysis therapies, using an artificial kidney. Nevertheless, the current therapies cannot remove a broad range of uremic toxins compared to the natural kidney. Adsorption therapies, using sorbent-based columns, can improve the clearance of uremic toxins, but the sorbent particles often require polymeric coatings to improve their haemocompatibility leading to mass transfer limitations and to lowering of their performance. Earlier, we have developed a dual layer Mixed Matrix fiber Membrane (MMM) based on polyethersulfone/polyvinylpyrrolidone (PES/PVP) polymer blends. There, the sorbent activated carbon particles are embedded in the outer membrane layer for achieving higher removal whereas the inner blood contacting selective membrane layer should achieve optimal blood compatibility. In this work, we evaluate in detail the haemocompatibility of the MMM following the norm ISO 10993-4. We study two generations of MMM having different dimensions and transport characteristics; one with low flux and no albumin leakage and another with high flux but some albumin leakage. The results are compared to those of home-made PES/PVP single layer hollow fiber and to various control fibers already applied in the clinic. Our results show that the low flux MMM successfully avoids contact of blood with the activated carbon and has good haemocompatibility, comparable to membranes currently used in the clinic. STATEMENT OF SIGNIFICANCE: Haemodialysis is a life-sustaining extracorporeal treatment for renal disease, however a broad range of uremic toxins cannot still be removed. In our previous works we showed that a double layer Mixed Matrix Membrane (MMM) composed of polyethersulfone/polyvinylpyrrolidone and activated carbon can achieve higher removal of uremic toxics compared to commercial haemodialysers. In this work we evaluate the haemocompatibility profile of the MMM in order to facilitate its clinical implementation. The lumen particle-free layer of the MMM successfully avoids the contact of blood with the poorly blood-compatible activated carbon. Moreover, thanks to the high amount of polyvinylpyrrolidone and to the smoothness of the lumen layer, the MMM has very good haemocompatibility, comparable to membranes currently used in the clinic.
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Affiliation(s)
- I Geremia
- (Bio)artificial organs, Department of Biomaterials Science and Technology, TechMed Centre, Faculty of Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
| | - D Pavlenko
- (Bio)artificial organs, Department of Biomaterials Science and Technology, TechMed Centre, Faculty of Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands
| | - K Maksymow
- eXcorLab GmbH, Industrie Center Obernburg, Obernburg, Germany
| | - M Rüth
- eXcorLab GmbH, Industrie Center Obernburg, Obernburg, Germany
| | - H D Lemke
- eXcorLab GmbH, Industrie Center Obernburg, Obernburg, Germany
| | - D Stamatialis
- (Bio)artificial organs, Department of Biomaterials Science and Technology, TechMed Centre, Faculty of Science and Technology, University of Twente, P.O. Box 217, 7500 AE Enschede, the Netherlands.
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Li Q, Yang J, Cai N, Zhang J, Xu T, Zhao W, Guo H, Zhu Y, Zhang L. Hemocompatible hemoadsorbent for effective removal of protein-bound toxin in serum. J Colloid Interface Sci 2019; 555:145-156. [PMID: 31377640 DOI: 10.1016/j.jcis.2019.07.045] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 07/13/2019] [Accepted: 07/16/2019] [Indexed: 12/27/2022]
Abstract
Resin hemoperfusion is a life-saving treatment for drug intoxication or hepatic failure of patients. However, current resin adsorbents exhibit a limited hemocompatibility or low adsorption efficiency, representing a major roadblock to successful clinical applications. In this work, we developed a hemocompatible and effective hemoadsorbent based on polystyrene resin (H103) microparticles encapsulated in anti-biofouling zwitterionic poly(carboxybetaine) (PCB) hydrogels. Apart from a strong mechanical stability, this PCB-based adsorbent (PCB-H103) exhibited excellent hemocompatibility (hemolysis ratio was ∼0.64%), which was attributed to the anti-biofouling property of PCB hydrogel. In addition, it can efficiently adsorb both small and middle molecular weight molecules in phosphate-buffered saline, and the efficiencies were significantly higher than poly(ethylene glycol) methacrylate-based and poly(2-hydroxyethyl methacrylate)-based adsorbent counterparts, indicating the favorable permeability of PCB hydrogel coating. More importantly, PCB-H103 could effectively remove protein-bound toxins including phenol red and bilirubin in bovine serum albumin solution or even in 100% fetal bovine serum (FBS). In 100% FBS, the adsorption capacity of PCB-H103 towards bilirubin was 8.3 times higher than that of pristine clinical-scale resin beads. Findings in this work may provide a new strategy for the development of modern resin hemoperfusion technology.
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Affiliation(s)
- Qingsi Li
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Jing Yang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Nana Cai
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Jiamin Zhang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Tong Xu
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Weiqiang Zhao
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Hongshuang Guo
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Yingnan Zhu
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China
| | - Lei Zhang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin 300072, PR China; Frontier Science Center for Synthetic Biology and Key Laboratory of Systems Bioengineering (MOE), School of Chemical Engineering and Technology, Tianjin University, Tianjin 300350, PR China; Qingdao Institute for Marine Technology of Tianjin University, Qingdao 266235, PR China; Collaborative Innovation Center of Chemical Science and Engineering (Tianjin), Tianjin University, Tianjin 300072, PR China.
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Chai Y, Chen J, Wang T, Chen J, Ma Y, Cheng G, Li C, Zhang Q, Ou L, Li W. Bead-type polystyrene/nano-CaCO 3 (PS/nCaCO 3) composite: a high-performance adsorbent for the removal of interleukin-6. J Mater Chem B 2019; 7:1404-1414. [PMID: 32255011 DOI: 10.1039/c8tb02504e] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
A novel nano-CaCO3 (nCaCO3) particle composite-derived polystyrene (PS) resin was successfully synthesized by a suspension polymerization method. The nCaCO3 reinforced PS material (PS/nCaCO3) possessed a structure with abundant mesopores of high porosity, high specific surface area (828.3 m2 g-1) and large pore volume (1.83 cm3 g-1). It was revealed that the incorporation of nCaCO3 into the PS matrix enhanced both the mechanical strength which can prevent the fragmentation and its adsorption capacity for interleukin-6 (IL-6, MW = 24.0 kDa) from human plasma. The adsorption isotherm could be described by the Langmuir model and classified as S-3 type, showing an IL-6 uptake of up to 25.6 ng g-1 at an equilibrium concentration of about 500 ng L-1. The adsorption capacity for IL-6 of PS/nCaCO3 is not only significantly higher than that of PS (without nCaCO3), but also superior to those of currently available adsorbents that are under clinical studies (e.g., CytoSorb™ towards cytokines). In addition, the PS/nCaCO3 adsorbent also had good hemocompatibility and showed no leakage of nCaCO3 in the plasma in a flowing model system. Therefore, the synthesized PS/nCaCO3 nano-composite has a great potential to be used as an efficient adsorbent for the removal of interleukin-6 (IL-6) from blood of inflammatory and auto-immune disease patients through hemoperfusion.
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Affiliation(s)
- Yamin Chai
- Key Laboratory of Bioactive Materials, Ministry of Education, College of Life Sciences, Nankai University, Tianjin, 300071, China.
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Singh A, Mehta Y, Trehan N. Bilirubin Removal Using CytoSorb Filter in a Cardiac Surgical Patient. J Cardiothorac Vasc Anesth 2018; 33:881-883. [PMID: 30292390 DOI: 10.1053/j.jvca.2018.08.213] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Ajmer Singh
- Department of Cardiac Anaesthesia, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurgaon, India
| | - Yatin Mehta
- Department of Cardiac Anaesthesia, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurgaon, India
| | - Naresh Trehan
- Department of Cardiac Surgery, Institute of Critical Care and Anesthesiology, Medanta-The Medicity, Gurgaon, India
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10
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Clearance of low molecular-weight uremic toxins p-cresol, creatinine, and urea from simulated serum by adsorption. J Mol Liq 2018. [DOI: 10.1016/j.molliq.2017.12.084] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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11
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Antifouling zwitterionic hydrogel coating improves hemocompatibility of activated carbon hemoadsorbent. J Colloid Interface Sci 2017; 503:168-177. [DOI: 10.1016/j.jcis.2017.04.024] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 04/06/2017] [Accepted: 04/07/2017] [Indexed: 11/17/2022]
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12
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Surface-Engineered Blood Adsorption Device for Hyperphosphatemia Treatment. ASAIO J 2017; 64:389-394. [PMID: 28799951 DOI: 10.1097/mat.0000000000000639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Correspondence: Melanie S. Joy, PharmD, PhD, University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutical Sciences, Mail Stop C238, Room V20-4108, 12850 East Montview Blvd, Aurora, CO 80045. Email: Melanie.Joy@ucdenver.edu The research employed surface engineering methods to develop, optimize, and characterize a novel textile-based hemoadsorption device for hyperphosphatemia in hemodialysis-dependent end-stage kidney disease. Phosphate adsorbent fabrics (PAFs) were prepared by thermopressing alumina powders to polyester filtration fabrics and treatment with trimesic acid (TMA). For static experiments, phosphate adsorption capacity in buffer solution, plasma, and blood were evaluated by submersing the PAFs in 100 ml. For dynamic experiments, PAFs were equipped in a device prototype and incorporated in a pump-driven circuit. Phosphates were determined by a colorimetric assay and an Ortho Clinical Diagnostics Vitros 5600 Integrated analyzer. The maximum loading amount of TMA-alumina on PAFs was approximately 35 g/m under 260°C processing temperature. Phosphate adsorption capacity increased with initial concentration. Adsorption isotherms from buffer demonstrated a maximum phosphate adsorption capacity of approximately 893 mg/m at 37.5°C, pH 7.4, with similar results from plasma and whole blood. Measured phosphate concentrations during simulations demonstrated a 42% reduction, confirming the high capacity of the PAFs for removing phosphate from whole blood. Results from the current study indicated that an alumina-TMA treated PAF can dramatically reduce phosphate concentrations from biological samples. The technology could potentially be used as a tunable adsorbent for managing hyperphosphatemia in kidney disease.
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Leshchinskaya A, Ezhova N, Pisarev O. Synthesis and characterization of 2-hydroxyethyl methacrylate-ethylene glycol dimethacrylate polymeric granules intended for selective removal of uric acid. REACT FUNCT POLYM 2016. [DOI: 10.1016/j.reactfunctpolym.2016.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
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14
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Cheah WK, Ishikawa K, Othman R, Yeoh FY. Nanoporous biomaterials for uremic toxin adsorption in artificial kidney systems: A review. J Biomed Mater Res B Appl Biomater 2016; 105:1232-1240. [PMID: 26913694 DOI: 10.1002/jbm.b.33475] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Revised: 05/03/2015] [Accepted: 06/05/2015] [Indexed: 12/22/2022]
Abstract
Hemodialysis, one of the earliest artificial kidney systems, removes uremic toxins via diffusion through a semipermeable porous membrane into the dialysate fluid. Miniaturization of the present hemodialysis system into a portable and wearable device to maintain continuous removal of uremic toxins would require that the amount of dialysate used within a closed-system is greatly reduced. Diffused uremic toxins within a closed-system dialysate need to be removed to maintain the optimum concentration gradient for continuous uremic toxin removal by the dialyzer. In this dialysate regenerative system, adsorption of uremic toxins by nanoporous biomaterials is essential. Throughout the years of artificial kidney development, activated carbon has been identified as a potential adsorbent for uremic toxins. Adsorption of uremic toxins necessitates nanoporous biomaterials, especially activated carbon. Nanoporous biomaterials are also utilized in hemoperfusion for uremic toxin removal. Further miniaturization of artificial kidney system and improvements on uremic toxin adsorption capacity would require high performance nanoporous biomaterials which possess not only higher surface area, controlled pore size, but also designed architecture or structure and surface functional groups. This article reviews on various nanoporous biomaterials used in current artificial kidney systems and several emerging nanoporous biomaterials. © 2016 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 105B: 1232-1240, 2017.
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Affiliation(s)
- Wee-Keat Cheah
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia Engineering Campus, 14300, Nibong Tebal, Penang, Malaysia
| | - Kunio Ishikawa
- Department of Biomaterials, Kyushu University, Fukuoka, Nishi Ward, Japan
| | - Radzali Othman
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia Engineering Campus, 14300, Nibong Tebal, Penang, Malaysia.,Faculty of Manufacturing Engineering, Universiti Teknikal Malaysia Melaka, Hang Tuah Jaya, 76100n, Durian Tunggal, Malacca, Malaysia
| | - Fei-Yee Yeoh
- School of Materials and Mineral Resources Engineering, Universiti Sains Malaysia Engineering Campus, 14300, Nibong Tebal, Penang, Malaysia
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15
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Inoue S, Kiriyama K, Hatanaka Y, Kanoh H. Adsorption properties of an activated carbon for 18 cytokines and HMGB1 from inflammatory model plasma. Colloids Surf B Biointerfaces 2014; 126:58-62. [PMID: 25543984 DOI: 10.1016/j.colsurfb.2014.12.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 12/07/2014] [Indexed: 10/24/2022]
Abstract
The ability of an activated carbon (AC) to adsorb 18 different cytokines with molecular weights ranging from 8 kDa to 70 kDa and high mobility group box-1 (HMGB1) from inflammatory model plasma at 310 K and the mechanisms of adsorption were examined. Porosity analysis using N2 gas adsorption at 77K showed that the AC had micropores with diameters of 1-2 nm and mesopores with diameters of 5-20 nm. All 18 cytokines and HMGB1 were adsorbed on the AC; however, the shapes of the adsorption isotherms changed depending on the molecular weight. The adsorption isotherms for molecules of 8-10 kDa, 10-20 kDa, 20-30 kDa, and higher molecular weights were classified as H-2, L-3, S-3, and S-1 types, respectively. These results suggested that the adsorption mechanism for the cytokines and HMGB1 in the mesopores and on the surface of the AC differed as a function of the molecular weight. On the basis of these results, it can be concluded that AC should be efficient for cytokine adsorption.
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Affiliation(s)
- Satoru Inoue
- Medical Material Laboratory, Asahi-Kasei Medical Co., Ltd., 2111-2, Oaza-sato, Oita 870-0396, Japan; Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi-cho, Inage, Chiba 263-8522, Japan
| | - Kentaro Kiriyama
- Medical Material Laboratory, Asahi-Kasei Medical Co., Ltd., 2111-2, Oaza-sato, Oita 870-0396, Japan
| | - Yoshihiro Hatanaka
- Medical Material Laboratory, Asahi-Kasei Medical Co., Ltd., 2111-2, Oaza-sato, Oita 870-0396, Japan
| | - Hirofumi Kanoh
- Department of Chemistry, Graduate School of Science, Chiba University, 1-33 Yayoi-cho, Inage, Chiba 263-8522, Japan.
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Pore Size – a Key Property for Selective Toxin Removal in Blood Purification. Int J Artif Organs 2014; 37:668-78. [DOI: 10.5301/ijao.5000354] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2014] [Indexed: 12/14/2022]
Abstract
Purpose Extracorporeal blood purification systems based on combined membrane/adsorption technologies are used in acute liver failure to replace detoxification as well as to remove inflammatory mediators in sepsis patients. In addition to coating and chemical modification of the surface, pore size significantly controls the selectivity of adsorption materials. Methods This study addresses the adsorption of albumin bound liver toxins, cytokines, and representative plasma compounds on three adsorbents which differ only in pore size distribution. All three adsorbents are based on hydrophobic poly(styrene-divinylbenzene) copolymer matrices and have mean pore sizes of 15, 30, and 100 nm. Results The pores of adsorbents act as molecular sieves and prevent the entry of molecules that are larger than their molecular cut-off. The results of this study reveal that adsorbents based on styrene-divinylbenzene polymers with 15 nm pores are suitable for cytokine removal, and the same adsorbents with 30-40 nm pores are the best choice for the removal of albumin-bound toxins in the case of liver failure. Adsorbents with very large pores lack selectivity which leads to uncontrolled adsorption of all plasma proteins. Therefore, hydrophobic adsorbents with large pores offer inadequate plasma compatibility and do not fulfill the requirements for blood purification. Conclusions Biocompatibility and efficiency of adsorbents used for blood purification can improved by fine tuning of adsorbent surface pore distributions.
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Rajpal S, Beedupalli J, Reddy P. Recrudescent digoxin toxicity treated with plasma exchange: a case report and review of literature. Cardiovasc Toxicol 2013; 12:363-8. [PMID: 22618329 DOI: 10.1007/s12012-012-9171-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A 53-year-old woman presented with digitalis toxicity caused by acute overdose that manifested as atrial tachycardia with block, sinus pauses, and competing AV junctional rhythm with atrial fibrillation. Patient admitted to overdosing with digoxin 15-20 h before presentation with intent to commit suicide. Serum digoxin level was 35.6 ng/ml and renal function was normal. Patient was treated with 1,040 mg of digoxin-specific antibody Fab fragment with prompt resolution of arrhythmias and restoration of sinus rhythm. Four hours after digoxin antibody administration, serum digoxin level declined to 0.2 ng/ml. Eighteen hours after treatment with Fab fragment, patient developed premature ventricular complexes, atrial tachycardia with and without atrioventricular block, and non-sustained ventricular tachycardia followed by ventricular fibrillation from which she was successfully resuscitated. Electrocardiogram showed no evidence of acute myocardial infarction, and emergent coronary angiogram did not reveal significant coronary artery disease. Repeat digoxin level was 20.4 ng/ml. A diagnosis of recrudescent digoxin toxicity was made and the patient was treated with one session of plasma exchange with resolution of arrhythmias. Immediately after plasma exchange, digoxin level decreased to 10.4 ng/ml, and after 10 h, the level further decreased to 6.6 ng/ml. The following day, digoxin level had decreased to 2.9 ng/ml. Our experience with this case would suggest that plasma exchange should be considered as a treatment modality for recrudescent digoxin toxicity.
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Affiliation(s)
- Saurabh Rajpal
- Department of Medicine, Louisiana State University Health Sciences Center, 1501 Kings Hwy, Shreveport, LA 71105, USA.
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Anisimova NY, Gromova EG, Kuznetsova LS, Sitdikova SM, Kiselevskii MV. Dynamics of elimination of bacterial endotoxins and cytokines from the blood of tumor patients with sepsis in hemoperfusion using carbon adsorbents. Bull Exp Biol Med 2012; 151:622-4. [PMID: 22462061 DOI: 10.1007/s10517-011-1398-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
We studied the effects of carbon adsorbent hemoperfusion on the dynamics of LPS and cytokine concentrations in the blood of cancer patients with sepsis and septic shock. In addition, hemadsorbent washout fluid specimens after hemoperfusion were analyzed. A significant (3-fold) reduction of blood LPS levels after hemoperfusion was found, while shifts in free cytokine levels in the sera were negligible. At the same time, hemadsorbents used in the study effectively eliminated some free cytokines (IL-6, -8, -12, IFN-γ, TNF-α) from the blood.
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Affiliation(s)
- N Yu Anisimova
- N. N. Blokhin Russian Oncological Research Center, Russian Academy of Medical Sciences, Moscow, Russia.
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Anisimova NY, Dolzhikova YI, Davankov VA, Pastukhov AV, Miljaeva SI, Senatov FS, Kiselevsky MV. Prospects for the application of biporous sorbents based on hypercrosslinked styrene polymers for the prevention and treatment of systemic purulent-septic complications. ACTA ACUST UNITED AC 2012. [DOI: 10.1134/s1995078012030020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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20
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Possibility of microorganism elimination from the blood using modified coal hemosorbents. Bull Exp Biol Med 2012; 151:273-4. [PMID: 22238767 DOI: 10.1007/s10517-011-1306-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We studied the possibility of using coal hemosorbents for elimination gram-positive and gram-negative microorganisms from the blood. After hemosorption, the number of S. aureus and K. pneumoniae pneumoniae colony-forming units significantly decreased. The obtained results indicate that coal sorbents can bind and probably eliminate gram-positive and gram-negative bacteria from the blood.
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Tripisciano C, Kozynchenko OP, Linsberger I, Phillips GJ, Howell CA, Sandeman SR, Tennison SR, Mikhalovsky SV, Weber V, Falkenhagen D. Activation-dependent adsorption of cytokines and toxins related to liver failure to carbon beads. Biomacromolecules 2011; 12:3733-40. [PMID: 21842874 DOI: 10.1021/bm200982g] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In the course of severe pathological conditions, such as acute liver failure and sepsis, toxic metabolites and mediators of inflammation are released into the patient's circulation. One option for the supportive treatment of these conditions is plasmapheresis, in which plasma, after being separated from the cellular components of the blood, is cleansed by adsorption of harmful molecules on polymers or activated carbon. In this work, the adsorption characteristics of activated carbon beads with levels of activation ranging from 0 to 86% were assessed for both hydrophobic compounds accumulating in liver failure (bilirubin, cholic acid, phenol and tryptophan) and cytokines (tumor necrosis factor α and interleukin-6). Progressive activation resulted in significant gradual reduction of both bulk density and mean particle size, in an increase in the specific surface area, and to changes in pore size distribution with progressive broadening of micropores. These structural changes went hand in hand with enhanced adsorption of small adsorbates, such as IL-6 and cholic acid and, to a lesser extent, also of large molecules, such as TNF-α.
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22
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Carr R, Comer J, Ginsberg MD, Aksimentiev A. Microscopic Perspective on the Adsorption Isotherm of a Heterogeneous Surface. J Phys Chem Lett 2011; 2:1804-1807. [PMID: 22611479 PMCID: PMC3353733 DOI: 10.1021/jz200749d] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Adsorption of dissolved molecules onto solid surfaces can be extremely sensitive to the atomic-scale properties of the solute and surface, causing difficulties for the design of fluidic systems in industrial, medical and technological applications. In this communication, we show that the Langmuir isotherm for adsorption of a small molecule to a realistic, heterogeneous surface can be predicted from atomic structures of the molecule and surface through molecular dynamics (MD) simulations. We highlight the method by studying the adsorption of dimethyl-methylphosphonate (DMMP) to amorphous silica substrates and show that subtle differences in the atomic-scale surface properties can have drastic effects on the Langmuir isotherm. The sensitivity of the method presented is sufficient to permit the optimization of fluidic devices and to determine fundamental design rules for controlling adsorption at the nanoscale.
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Affiliation(s)
- Rogan Carr
- Department of Physics, University of Illinois, Urbana, IL
| | - Jeffrey Comer
- Department of Physics, University of Illinois, Urbana, IL
| | | | - Aleksei Aksimentiev
- Department of Physics, University of Illinois, Urbana, IL
- Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL
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Temperature-programmed desorption as a tool for quantification of protein adsorption capacity in micro- and nanoporous materials. Colloids Surf B Biointerfaces 2009; 73:168-74. [DOI: 10.1016/j.colsurfb.2009.05.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2009] [Revised: 05/12/2009] [Accepted: 05/12/2009] [Indexed: 11/24/2022]
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Yushin G, Hoffman EN, Barsoum MW, Gogotsi Y, Howell CA, Sandeman SR, Phillips GJ, Lloyd AW, Mikhalovsky SV. Mesoporous carbide-derived carbon with porosity tuned for efficient adsorption of cytokines. Biomaterials 2006; 27:5755-62. [PMID: 16914195 DOI: 10.1016/j.biomaterials.2006.07.019] [Citation(s) in RCA: 110] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2006] [Accepted: 07/17/2006] [Indexed: 11/21/2022]
Abstract
Porous carbons can be used for the purification of various bio-fluids, including the cleansing blood of inflammatory mediators in conditions such as sepsis or auto-immune diseases. Here we show that the control of pore size in carbons is a key factor to achieving efficient removal of cytokines. In particular, the surface area accessible by the protein governs the rate and effectiveness of the adsorption process. We demonstrate that novel mesoporous carbon materials synthesized from ternary MAX-phase carbides can be optimized for efficient adsorption of large inflammatory proteins. The synthesized carbons, having tunable pore size with a large volume of slit-shaped mesopores, outperformed all other materials or methods in terms of efficiency of TNF-alpha removal and the results are comparable only with highly specific antibody-antigen interactions.
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Affiliation(s)
- Gleb Yushin
- Department of Materials Science and Engineering and A.J. Drexel Nanotechnology Institute, Drexel University, Philadelphia, PA 19104, USA
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Mikhalovsky S, Nikolaev V. Chapter 11 Activated carbons as medical adsorbents. INTERFACE SCIENCE AND TECHNOLOGY 2006. [DOI: 10.1016/s1573-4285(06)80020-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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Sandeman SR, Howell CA, Phillips GJ, Lloyd AW, Davies JG, Mikhalovsky SV, Tennison SR, Rawlinson AP, Kozynchenko OP, Owen HLH, Gaylor JDS, Rouse JJ, Courtney JM. Assessing the in vitro biocompatibility of a novel carbon device for the treatment of sepsis. Biomaterials 2005; 26:7124-31. [PMID: 15967498 DOI: 10.1016/j.biomaterials.2005.05.019] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2005] [Accepted: 05/06/2005] [Indexed: 10/25/2022]
Abstract
The aim of the present study was to conduct a preliminary investigation into the blood biocompatibility of a novel, uncoated carbon for use in a filtration/adsorption device for the treatment of sepsis. Carbon well prototypes were manufactured from phenol-formaldehyde-aniline-based pyrolysed carbons using monolithic polymer technology. Inflammatory blood cell and plasma protein mediation of the inflammatory response were evaluated using the novel carbon prototypes and compared with dialyser membrane and tissue culture plate controls. Assays determining monocyte and granulocyte adhesion, platelet adhesion and activation, granulocyte activation and complement activation were performed. Preliminary findings suggest an adsorptive but passivating carbon surface. Moderate levels of monocyte and granulocytes adhesion were seen in conjunction with adsorption of plasma proteins to the carbon surface. Activation of granulocyte and adherent platelets was not detected and the complement cascade was not activated by the carbons, indicating a surface compatible with blood contact. The results support the further development of the proposed carbon-based device for the treatment of sepsis.
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Affiliation(s)
- Susan R Sandeman
- Biomedical Materials Research Group, School of Pharmacy and Biomolecular Sciences, University of Brighton, UK
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Abstract
This study introduces a newly developed method for the formation of a stationary phase superficially embedded with immunoadsorbent, that is partially incomplete two-stage polymerization of acrylamide. Preliminary experimental studies show that binding activity of the immunoadsorbent was satisfactorily maintained after immobilization. With an appropriate configuration of selected immunoadsorption matrices and immunoisolation barriers, it is hoped that this stationary phase could be used to resolve some difficult problems arising from the accumulation of certain middle molecular weight toxins not removed by other blood purification procedures.
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Affiliation(s)
- Tsung-Hua Yang
- Department of Chemical Engineering, Cheng Shiu University, Kaohsiung, Taiwan, Republic of China.
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