A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.

Septic shock has a clinical mortality rate approaching fifty percent. The major clinical manifestations of sepsis are due to the dysregulation of the host's response to infection rather than the direct consequences of the invading pathogen. Central to this initial immunologic response is the ac...

Full description

Bibliographic Details
Main Authors: Feng Ding, Joon Ho Song, Ju Young Jung, Liandi Lou, Min Wang, Linda Charles, Angela Westover, Peter L Smith, Christopher J Pino, Deborah A Buffington, H David Humes
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2011-04-01
Series:PLoS ONE
Online Access:http://europepmc.org/articles/PMC3077371?pdf=render
_version_ 1818964827130822656
author Feng Ding
Joon Ho Song
Ju Young Jung
Liandi Lou
Min Wang
Linda Charles
Angela Westover
Peter L Smith
Christopher J Pino
Deborah A Buffington
H David Humes
author_facet Feng Ding
Joon Ho Song
Ju Young Jung
Liandi Lou
Min Wang
Linda Charles
Angela Westover
Peter L Smith
Christopher J Pino
Deborah A Buffington
H David Humes
author_sort Feng Ding
collection DOAJ
description Septic shock has a clinical mortality rate approaching fifty percent. The major clinical manifestations of sepsis are due to the dysregulation of the host's response to infection rather than the direct consequences of the invading pathogen. Central to this initial immunologic response is the activation of leukocytes and microvascular endothelium resulting in cardiovascular instability, lung injury and renal dysfunction. Due to the primary role of leukocyte activation in the sepsis syndrome, a synthetic biomimetic membrane, called a selective cytopheretic device (SCD), was developed to bind activated leukocytes. The incorporation of the SCD along an extracorporeal blood circuit coupled with regional anticoagulation with citrate to lower blood ionized calcium was devised to modulate leukocyte activation in sepsis.Laboratory investigation.University of Michigan Medical School.Pigs weighing 30-35 kg.To assess the effect of the SCD in septic shock, pigs were administered 30×10(10) bacteria/kg body weight of Escherichia coli into the peritoneal cavity and within 1 hr were immediately placed in an extracorporeal circuit containing SCD.In this animal model, the SCD with citrate compared to control groups without the SCD or with heparin anticoagulation ameliorated the cardiovascular instability and lung sequestration of activated leukocytes, reduced renal dysfunction and improved survival time compared to various control groups. This effect was associated with minimal elevations of systemic circulating neutrophil activation.These preclinical studies along with two favorable exploratory clinical trials form the basis of an FDA-approved investigational device exemption for a pivotal multicenter, randomized control trial currently underway.
first_indexed 2024-12-20T13:07:18Z
format Article
id doaj.art-38014fe617d64ab69af064a9ad50040d
institution Directory Open Access Journal
issn 1932-6203
language English
last_indexed 2024-12-20T13:07:18Z
publishDate 2011-04-01
publisher Public Library of Science (PLoS)
record_format Article
series PLoS ONE
spelling doaj.art-38014fe617d64ab69af064a9ad50040d2022-12-21T19:39:44ZengPublic Library of Science (PLoS)PLoS ONE1932-62032011-04-0164e1858410.1371/journal.pone.0018584A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.Feng DingJoon Ho SongJu Young JungLiandi LouMin WangLinda CharlesAngela WestoverPeter L SmithChristopher J PinoDeborah A BuffingtonH David HumesSeptic shock has a clinical mortality rate approaching fifty percent. The major clinical manifestations of sepsis are due to the dysregulation of the host's response to infection rather than the direct consequences of the invading pathogen. Central to this initial immunologic response is the activation of leukocytes and microvascular endothelium resulting in cardiovascular instability, lung injury and renal dysfunction. Due to the primary role of leukocyte activation in the sepsis syndrome, a synthetic biomimetic membrane, called a selective cytopheretic device (SCD), was developed to bind activated leukocytes. The incorporation of the SCD along an extracorporeal blood circuit coupled with regional anticoagulation with citrate to lower blood ionized calcium was devised to modulate leukocyte activation in sepsis.Laboratory investigation.University of Michigan Medical School.Pigs weighing 30-35 kg.To assess the effect of the SCD in septic shock, pigs were administered 30×10(10) bacteria/kg body weight of Escherichia coli into the peritoneal cavity and within 1 hr were immediately placed in an extracorporeal circuit containing SCD.In this animal model, the SCD with citrate compared to control groups without the SCD or with heparin anticoagulation ameliorated the cardiovascular instability and lung sequestration of activated leukocytes, reduced renal dysfunction and improved survival time compared to various control groups. This effect was associated with minimal elevations of systemic circulating neutrophil activation.These preclinical studies along with two favorable exploratory clinical trials form the basis of an FDA-approved investigational device exemption for a pivotal multicenter, randomized control trial currently underway.http://europepmc.org/articles/PMC3077371?pdf=render
spellingShingle Feng Ding
Joon Ho Song
Ju Young Jung
Liandi Lou
Min Wang
Linda Charles
Angela Westover
Peter L Smith
Christopher J Pino
Deborah A Buffington
H David Humes
A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
PLoS ONE
title A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
title_full A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
title_fullStr A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
title_full_unstemmed A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
title_short A biomimetic membrane device that modulates the excessive inflammatory response to sepsis.
title_sort biomimetic membrane device that modulates the excessive inflammatory response to sepsis
url http://europepmc.org/articles/PMC3077371?pdf=render
work_keys_str_mv AT fengding abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT joonhosong abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT juyoungjung abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT liandilou abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT minwang abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT lindacharles abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT angelawestover abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT peterlsmith abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT christopherjpino abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT deborahabuffington abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT hdavidhumes abiomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT fengding biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT joonhosong biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT juyoungjung biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT liandilou biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT minwang biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT lindacharles biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT angelawestover biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT peterlsmith biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT christopherjpino biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT deborahabuffington biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis
AT hdavidhumes biomimeticmembranedevicethatmodulatestheexcessiveinflammatoryresponsetosepsis