CytoSorbents Corporation (CTSO)

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New Publications

1. Clinical data 1.3 Case Reports

1.3.3 Liver
NEW: Application of Hemoadsorption in a Case of Liver Cirrhosis and AlcoholRelated Steatohepatitis with Preexisting Hepatitis C Infection. Buttner S, Patyna S, Koch B, Finkelmeier F, Geiger H, Sarrazin C, Farnik H. Blood Purif 2017; 44(1): 30-31

1.3.5 Other Indications NEW: Rescue of cytokine storm due to HLH by hemoadsorption in a CTLA4deficient patient Greil C, Roether F, La Rosée P, Grimbacher B, Duerschmied D, Warnatz K Journal of Clinical Immunology 2017; epub

2. Preclinical Data 2.1 Animal Models NEW: Effects of Blood Purification on Serum Levels of Inflammatory Cytokines and Cardiac Function in a Rat Model of Sepsis Lin CM, Chen CR, Wu XQ, Ren JH, Chen SZ, Luo XF, Mei XQ, Shen LY, Guo MX, Ma XD, Yang T. Blood Purif 2017: 44(1): 40-50

1.3.3. Liver
NEW: Application of Hemoadsorption in a Case of Liver Cirrhosis and AlcoholRelated Steatohepatitis with Preexisting Hepatitis C Infection. Buttner S, Patyna S, Koch B, Finkelmeier F, Geiger H, Sarrazin C, Farnik H. Blood Purif 2017; 44(1): 30-31 ??? Summary: This is the first case study that confirms the successful direct removal of liver toxins, including ammonia and bile acids by the CytoSorb. In this report a 36year-old patient with chronic viral hepatitis C and long term chronic alcohol abuse was admitted to ICU with decompensated ethanol toxic liver cirrhosis. Despite an initial attempt to stabilize the patient using an albumin infusion and multiple paracenteses the patient developed hepatorenal syndrome and subsequent dialysis dependency. During this time, an evaluation as to whether the patient could be listed for a liver transplantation was rejected. As a „last resort“ therapy, CytoSorb treatment was initiated with the rationale to remove inflammation-triggering factors and liver toxins (bile acids, bilirubin, ammonia) in the context of his systemic inflammatory condition as well as his acute-onchronic liver failure. In total two treatments with CytoSorb were carried out for 6 hours each with a treatment pause of 5 days between adsorbers due to nonexistent evidence of use in this kind of patient. Pre and post adsorber measurements during the second treatment confirmed efficient removal of ammonia, bilirubin and bile acids. After initially recovering well with planned discharge to his home environment, the patient subsequently developed a nosocomial pneumonia, after which the patient went into another episode of fulminant pneumogenic sepsis and died three weeks after the last CytoSorb treatment. In this case report, the treatment with combination of CRRT and hemoadsorption using CytoSorb worked extremely well and effectively as a liver support. As a consequence, hepatic encephalopathy improved significantly due to efficient removal of liver toxins including ammonia.
https://www.ncbi.nlm.nih.gov/pubmed/28237980


1.3.5. Other indications
NEW: Rescue of cytokine storm due to HLH by hemoadsorption in a CTLA4deficient patient Greil C, Roether F, La Rosée P, Grimbacher B, Duerschmied D, Warnatz K Journal of Clinical Immunology 2017; epub ?? Summary In this letter to the editor the authors describe the use of a CytoSorb in a patient with secondary hemophagocytic lymphohistiocytes (HLH) caused by CTLA-4 deficiency. CTLA-4 deficiency is caused by a heterozygous germ line mutation of the cytotoxic T lymphocytic antigen-4 (CTLA-4) gene leading to a syndrome with prominent features of immune dysregulation. HLH is characterized by fever, splenomegaly, bicytopenia, highly elevated serum levels of ferritin and soluble interleukin-2 receptor (sIL2-R), decreased natural killer (NK) cell activity, hypertriglyceridemia and detection of hemophagocytosis in bone marrow or other tissue. To date, HLH has never been described in a patient with CTLA-4 deficiency. A 50 yr old patient was admitted to ICU with SIRS and multi-organ failure. Despite aggressive intervention his clinical condition rapidly worsened so a CytoSorb adsorber was added into the circuit of the hemodiafiltration. In total 4 adsorbers were used, with columns being changed every 24 hrs. Cytokine adsorption resulted in an immediate decrease in inflammatory parameters, the clinical condition improved in parallel. This suggests the CytoSorb was the decisive therapeutic intervention in this case. The patient was discharged to the regular ward nine days after CytoSorb initiation.
https://www.ncbi.nlm.nih.gov/pubmed/28265964

2.1. Animal models
NEW: Effects of Blood Purification on Serum Levels of Inflammatory Cytokines and Cardiac Function in a Rat Model of Sepsis Lin CM, Chen CR, Wu XQ, Ren JH, Chen SZ, Luo XF, Mei XQ, Shen LY, Guo MX, Ma XD, Yang T. Blood Purif 2017: 44(1): 40-50 ??? Summary: This sepsis rat model study explored the effects of blood purification, using a modified CytoSorb adsorber, on serum levels of inflammatory cytokines (IL6, TNF, IL10,) and cardiac function. The rat model of sepsis was established by cecal ligation and puncture. Rats were divided into normal control (n=8), sham operation (n=32), model (n=32), sham treatment (n=32), and BP treatment groups (n=32). Cardiac function, inflammatory cytokines, myocardial enzymes, pathological score of cardiac muscle tissue, and myocardial apoptosis of rats in each group were compared. Results showed that the sepsis rats had higher serum levels of inflammatory cytokines and lower cardiac function than those in the normal control and sham operation groups. Importantly, compared with the model and sham treatment groups, the CytoSorb treated group showed improved cardiac function, decreased inflammatory cytokines and myocardial enzymes, a lower pathological score, less myocardial apoptosis and a much lower mortality. The authors conclude that blood purification using CytSorb may reduce serum levels of inflammatory cytokines and improve cardiac function of septic rats.

https://www.ncbi.nlm.nih.gov/pubmed/28241128

http://cytosorb-therapie.de/wp-content/uploads/2017/03/EN_Literature-list-CytoSorb_2017-Mar2.pdf