Cytokine adsorbing columns.

Sepsis induces the activation of complement and the release of inflammatory cytokines such as TNF-alpha and IL-1beta. The inflammatory cytokines and nitric oxide induced by sepsis can decrease systemic vascular resistance, resulting in profound hypotension. The combination of hypotension and microvascular occlusion results in tissue ischemia and ultimately leads to multiple organ failure. Recently, several experimental and clinical studies have reported that treatment for adsorption of cytokines is beneficial during endotoxemia and sepsis. Therefore, the present article discusses cytokine adsorbing columns. These columns, such as CytoSorb, CYT-860-DHP, Lixelle, CTR-001 and MPCF-X, the structures of which vary significantly, have excellent adsorption rates for inflammatory cytokines such as TNF-alpha, IL-1beta, IL-6 and IL8. Many studies have demonstrated that treatment with cytokine adsorbing columns has beneficial effects on the survival rate and inflammatory responses in animal septic models. Moreover, several cases have been reported in which treatment with cytokine adsorbing columns is very effective in hemodynamics and organ failures in critically ill patients. Although further investigations and clinical trials are needed, in the future treatment with cytokine adsorbing columns may play a major role in the treatment of hypercytokinemia such as multiple organ failure and acute respiratory distress syndrome. Copyright 2010 S. Karger AG, Basel.