New approach to endotoxic and septic shock by means of polymyxin B immobilized fiber.

Endotoxin shock therapy has not been successfully dealt with pharmacologically. Circulation of endotoxins in the blood is an important factor in the pathogenesis and clinical symptoms of endotoxic shock. We have recently developed polymyxin immobilized fiber (PMX-F) as a biomaterial for selectively detoxifying endotoxins. In ex vivo experiments, direct hemoperfusion (DHP) by PMX-F was performed on dogs injected with purified endotoxin. Only one of eight survived in the control group, but ten of 12 survived in the group receiving DHP with PMX-F. Mortality in the treated group decreased remarkably. Thus, the results indicate the efficacy of PMX-F in neutralizing endotoxins. By the same method as already mentioned, DHP with PMX-F was carried out on live dogs with Escherichia coli induced sepsis. All of the dogs in the control group died within 18 hours after bacterial infusion. All of the dogs in the treated group, however, survived for more than three days. Two of the five dogs are still alive. One of the remaining two survived for seven days and the other, 14. We found that PMX-F treatment prolonged or increased the survival rate in the endotoxic and septic dogs.