From Yahoo MB
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Groundbreaking paper with Cytosorb published in Nature.com: detailed analysis of adsorbed molecular compounds
triggering the hemodynamic instability of blood vessels and subsequent multi organ failure
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Why is this paper groundbreaking? It clarifies the mechanism of action concerning the reversal and prevention of organ damage - which is the root cause for death in the setting of a septic shock. The authors clearly demonstrate, by analyzing the CytoSorb adsorbed mixture of molecules (cytokines, chemokines, pamps, damps, activated complement....), that a very specific and small fraction of these adsorbed and in the blood circulating molecular entities are responsible for the impairment of the circulatory system. This small fraction of circulating and by CytoSorb adsorbed molecules is composed of an till now unidentified protein highly enriched with nucleic acids (free DNA and RNA released by cell damage or maybe intentionally sheded by cells to trap pathogens) in the size range of 15 kilodalton.
The authors tested 39 fractions of molecular material adsorbed from whole blood by CytoSorb by washing this out of the used adsorbers - but just 3 of these 39 fraction had an adverse effect on endothelial function (proper function of the blood vessel lining), while all others had not. The adverse effects are cell death (apoptosis), reduced ATP content (means reduced cellular metabolism) and inhibition of proliferation (means that the endothel will not be repaired after injury).
These findings also explain, why all other trials with other interventions in a sepsis setting finally fail - because the root cause for endothelial failure and patients death is just a small but very specific subset of all released DAMPS and PAMPS and cytokines and LPS and myoglobin/hemoglobin, ...... This does not mean that it is not beneficial to remove these additional signals - because it is also good to interrupt the inflammatory cascade which is of course moderated by cytokines, but it demonstrates that the final mechanism leading to death of a patient by the impairment of the blood vessel system and resulting multi organ failure during sepsis is now more specifically identified and can be managed by CytoSorb. GROUNDBRAKING NEWS for me and the medical community. You can find the paper by Google using the term: “Bioassay for endothelial Damage Mediators Retrieved by Hemoadsorption”. Yahoo didn’t allow to post a link – sorry.
