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Background: Neutrophil-platelet complexes (NPCs) readily migrate into tissues and induce tissue damage via cytokine or other pathogenic factors release. These actions are involved in onset and progression of acute respiratory distress syndrome (ARDS). Thus, simultaneous removal of cytokines and activated neutrophils that includes NPCs by blood purification may prevent development of ARDS and enhance drug effects. The goal of this study was to examine the effect of a newly developed adsorption column (NOA-001) that eliminates cytokines and activated neutrophils in a lung injury model.Results: Adsorption of cytokines such as IL-8, IL-6 and HMGB-1, and NPCs was first measured in vitro. Lung injury was induced by HCl and lipopolysaccharide intratracheal infusion in rabbits ventilated at a low tidal volume (7-8 mL/kg) and PEEP (2.5 cmH2O) for lung protection. Arterial blood gas, hematologic values, plasma IL-8, blood pressure and heart rate were measured, and lung damage was evaluated histopathologically in animals treated with 8-hour direct hemoperfusion with or without use of NOA-001. The in vitro adsorption rates for IL-8, IL-6, HMGB-1, activated granulocytes and NPCs were 99.4 ± 0.0164%, 63.6 ± 0.367%, 59.0 ± 1.58%, 7.05 ± 9.63% and 55.7 ± 12.7%, respectively. Absorption of NPCs onto fibers was confirmed microscopically. These adsorption effects were associated with several improvements in the rabbit model. In respiratory function, the PaO2/FIO2 ratios at 8 h were 314 ± 55.3 mmHg in the NOA-001 group and 134 ± 40.8 mmHg in the sham group. The oxygenation index and PaCO2 also differed significantly between the two groups (p |
