Extracorporeal cell therapy with granulocytes in a pig model of Gram-positive sepsis.

Abstract:

OBJECTIVES:Granulocyte transfusions have been used to treat immune cell dysfunction in sepsis. As granulocyte transfusions can trigger tissue injury via local effects of neutrophils, we hypothesized that extracorporeal treatment of plasma using granulocytes would prove beneficial while having less side effects. DESIGN:Prospective controlled three-armed animal study. SETTING:Research laboratory. SUBJECTS:Twenty-one female immature pigs (7.5-12 kg, 7-9 weeks old). INTERVENTIONS:Three groups of spontaneously breathing, sedated pigs (n = 7 each) received an intravenous lethal dose of live Staphylococcus aureus over 1 hour. Although group I had no specific treatment (control), group II and III were subsequently treated for 4 hours with an extracorporeal device containing either no cells (sham control, group II) or human cell line-derived granulocytic cells (group III). Survival time and physiologic, biochemical, and hematologic parameters were monitored for 7 days. MEASUREMENTS AND MAIN RESULTS:All animals of group I died during the observation time (mean survival time: 70 hours). In group II, two of seven and in group III, six of seven animals survived the observation time (mean survival: 75 and 168 hours, respectively). Survival differences were significant between group I and III (p < 0.001) and between group II and III (p < 0.05) but not between group I and II (p = 0.43). Furthermore, group differences in bacterial blood concentrations, differential blood count, blood gases, lactate, and interleukins were observed. The extracorporeal cell treatment was well tolerated by the animals. CONCLUSIONS:Extracorporeal therapy with granulocytic cells significantly improved survival in a pig model of sepsis. Further studies with this approach are encouraged.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Sauer M,Altrichter J,Kreutzer HJ,Lögters T,Scholz M,Nöldge-Schomburg G,Schmidt R,Mitzner SR

doi

10.1097/CCM.0b013e318194aa77

subject

Has Abstract

pub_date

2009-02-01 00:00:00

pages

606-13

issue

2

eissn

0090-3493

issn

1530-0293

journal_volume

37

pub_type

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