Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review
The “normal” immune response to an insult triggers a highly regulated response determined by the interaction of various immunocompetent cells with pro- and anti-inflammatory cytokines. Under pathologic conditions, the massive elevation of cytokine levels (“cytokine storm”) could not be controlled un...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | International Journal of Molecular Sciences |
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| Online Access: | https://www.mdpi.com/1422-0067/22/23/12786 |
| _version_ | 1797507759768338432 |
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| author | Thomas Köhler Elke Schwier Janina Praxenthaler Carmen Kirchner Dietrich Henzler Claas Eickmeyer |
| author_facet | Thomas Köhler Elke Schwier Janina Praxenthaler Carmen Kirchner Dietrich Henzler Claas Eickmeyer |
| author_sort | Thomas Köhler |
| collection | DOAJ |
| description | The “normal” immune response to an insult triggers a highly regulated response determined by the interaction of various immunocompetent cells with pro- and anti-inflammatory cytokines. Under pathologic conditions, the massive elevation of cytokine levels (“cytokine storm”) could not be controlled until the recent development of hemoadsorption devices that are able to extract a variety of different DAMPs, PAMPs, and metabolic products from the blood. CytoSorb<sup>®</sup> has been approved for adjunctive sepsis therapy since 2011. This review aims to summarize theoretical knowledge, in vitro results, and clinical findings to provide the clinician with pragmatic guidance for daily practice. English-language and peer-reviewed literature identified by a selective literature search in PubMed and published between January 2016 and May 2021 was included. Hemoadsorption can be used successfully as adjunct to a complex therapeutic regimen for various conditions. To the contrary, this nonspecific intervention may potentially worsen patient outcomes in complex immunological processes. CytoSorb<sup>®</sup> therapy appears to be safe and useful in various diseases (e.g., rhabdomyolysis, liver failure, or intoxications) as well as in septic shock or cytokine release syndrome, although a conclusive assessment of treatment benefit is not possible and no survival benefit has yet been demonstrated in randomized controlled trials. |
| first_indexed | 2024-03-10T04:53:01Z |
| format | Article |
| id | doaj.art-24eb161942154a87ae7488d83ba00bb6 |
| institution | Directory Open Access Journal |
| issn | 1661-6596 1422-0067 |
| language | English |
| last_indexed | 2024-03-10T04:53:01Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | International Journal of Molecular Sciences |
| spelling | doaj.art-24eb161942154a87ae7488d83ba00bb62023-11-23T02:28:03ZengMDPI AGInternational Journal of Molecular Sciences1661-65961422-00672021-11-0122231278610.3390/ijms222312786Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping ReviewThomas Köhler0Elke Schwier1Janina Praxenthaler2Carmen Kirchner3Dietrich Henzler4Claas Eickmeyer5Department of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyDepartment of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyDepartment of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyDepartment of General and Visceral Surgery, Thoracic Surgery and Proctology, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyDepartment of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyDepartment of Anesthesiology, Surgical Intensive Care, Emergency and Pain Medicine, Ruhr University Bochum, Klinikum Herford, 32120 Herford, GermanyThe “normal” immune response to an insult triggers a highly regulated response determined by the interaction of various immunocompetent cells with pro- and anti-inflammatory cytokines. Under pathologic conditions, the massive elevation of cytokine levels (“cytokine storm”) could not be controlled until the recent development of hemoadsorption devices that are able to extract a variety of different DAMPs, PAMPs, and metabolic products from the blood. CytoSorb<sup>®</sup> has been approved for adjunctive sepsis therapy since 2011. This review aims to summarize theoretical knowledge, in vitro results, and clinical findings to provide the clinician with pragmatic guidance for daily practice. English-language and peer-reviewed literature identified by a selective literature search in PubMed and published between January 2016 and May 2021 was included. Hemoadsorption can be used successfully as adjunct to a complex therapeutic regimen for various conditions. To the contrary, this nonspecific intervention may potentially worsen patient outcomes in complex immunological processes. CytoSorb<sup>®</sup> therapy appears to be safe and useful in various diseases (e.g., rhabdomyolysis, liver failure, or intoxications) as well as in septic shock or cytokine release syndrome, although a conclusive assessment of treatment benefit is not possible and no survival benefit has yet been demonstrated in randomized controlled trials.https://www.mdpi.com/1422-0067/22/23/12786hemoadsorptionCytoSorb<sup>®</sup>amount of blood purifiedCOVID-19immune systemcytokines |
| spellingShingle | Thomas Köhler Elke Schwier Janina Praxenthaler Carmen Kirchner Dietrich Henzler Claas Eickmeyer Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review International Journal of Molecular Sciences hemoadsorption CytoSorb<sup>®</sup> amount of blood purified COVID-19 immune system cytokines |
| title | Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review |
| title_full | Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review |
| title_fullStr | Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review |
| title_full_unstemmed | Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review |
| title_short | Therapeutic Modulation of the Host Defense by Hemoadsorption with CytoSorb<sup>®</sup>—Basics, Indications and Perspectives—A Scoping Review |
| title_sort | therapeutic modulation of the host defense by hemoadsorption with cytosorb sup r sup basics indications and perspectives a scoping review |
| topic | hemoadsorption CytoSorb<sup>®</sup> amount of blood purified COVID-19 immune system cytokines |
| url | https://www.mdpi.com/1422-0067/22/23/12786 |
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