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Purified GC remain functional after 72h of storage and additional 24h in the circulating treatment model. Cytokine secretion patterns revealed a significant increase, especially between 10 and 24h of treatment. Extending treatment time holds promise for enhancing immune response against sepsis-induced immunoparalysis. These findings provide valuable insights for optimizing immune-targeted therapeutic interventions.
GCs prepared from pooled buffy coats provide a precious alternative to granulocytes obtained from apheresis. Reduction of red blood cells and platelets by more than 90% extends the maximum shelf life of GCs from 24 h to 72 h. For a therapeutic dose of at least 1 × 1010 granulocytes, 15–20 buffy coats are required.
The extracorporeal treatment with donor granulocytes appeared to be well tolerated and showed promising efficacy results, encouraging further studies.
A significant reduction in RBC (98%) through sedimentation, and platelets (96%) by washing, purified the white blood cell (WBC) population and enriched the granulocytes to 96% of the WBC in the pGC. After 72 h of storage, over 90% of the initial WBC count of pGC remained, was viable (≥97%), and the granulocytes exhibited a high phagocytosis and oxidative burst functionality, comparable to sGC after 24 h.
Experimental extracorporeal cell treatment adds another approach to the field. Preliminary results include improved cellular immunocompetence, stabilized hemodynamics, and improved critical care scores.
In this ex vivo study high functionality of immune cells was adequately preserved even after 3 days of storage and also in extracorporeal circuits with sepsis plasma. This is a promising indicator of the functionality of the technology and encourages further clinical studies.
Results demonstrate the suitability of a simplified extracorporeal system. Furthermore, granulocytes remain viable and highly active during a 6-h treatment even after storage for 3 days supporting the treatment of septic patients with this system in advanced clinical trials.
The extracorporeal treatment with donor granulocytes showed promising effects on dosage of norepinephrine in patients, liver cell function, and viability in a cell based biosensor. Further studies with this approach are encouraged.
Ten patients with severe sepsis were treated twice with the granulocyte bioreactor. The cells used were screened for functionality; blood gas, glucose and lactate levels were obtained from the circuit of the bioreactor. Five patients were treated with an oxygenator setup (oxy group), five without an oxygenator (non-oxy group).
Extracorporeal therapy with granulocytic cells significantly improved survival in a pig model of sepsis. Further studies with this approach are encouraged.
Extracorporeal therapy with online centrifugation and plasma filtration significantly improved survival in a pig model of sepsis. Further studies with this approach are encouraged.
Extracorporeal therapy consisting of online centrifugation and plasma filtration with 100% pig plasma as replacement fluid significantly improved survival in a pig model of sepsis. Further studies with this approach are encouraged.
This article discusses the possibility of using preconditioned human phagocytes in an extracorporeal system to adsorb viral pathogens. Data are presented from in vitro experiments. Adsorption of an enterovirus and hepatitis B virus (HBV) was tested by a preconditioned human promyelocyte cell line.
The study assessed the safety of an extracorporeal immune support system with granulocyte cells in a rat model of Gram-negative sepsis. The data suggested that the extracorporeal use of granulocytes enables the therapeutic use of these cells, while avoiding adverse effects due to direct contact with internal organs.
In this paper, the authors discussed the possibility of using preconditioned cells in an extracorporeal biohybrid immune support system. Extracorporeal bioreactor experiments seem to be feasible to test the benefit in immunoparalysis‐associated diseases like SIRS or sepsis.
It is a second prospective study with 99 septic patients to test a new cell-based cytotoxicity device (biosensor) and to assess the clinical relevance for the early detection of liver dysfunction and prognostic capacity. The biosensor may be an early detection tool for hepatic dysfunction in septic patients and could be of prognostic relevance.
In a prospective clinical experimental study, the hepatotoxicity of plasma from septic and non-septic patients was tested. The plasma from patients with septic shock impaired the cell functions of HepG2 / C3A cells.
The authors discussed the predictive potential of cf-DNA/NETs for mortality in patients with severe burn injury. cf-DNA/NETs seems to be a rapid, valuable marker for prediction of mortality in burn patients.
Septic arthritis is associated with significantly increased values of synovial kynurenine. Furthermore, kynurenine inhibits proliferation of chondrocytes, which strongly suggests a pathophysiological effect of kynurenine on cartilage in inflammatory arthropathies.
This review summarizes current knowledge about the relation of NETs in a broad spectrum of clinical settings. Specifically, the authors focused on the importance of NETs as a predictive marker in severely ill patients. In addition, authors discussed the potential pathophysiology of NETs.
Both increased kynurenine values and kynurenine-tryptophan ratios predicted posttraumatic development of sepsis and organ failure. This ought to be validated in subsequent studies.
Circulating free DNA/NETs seems to be a valuable additional marker for the calculation of injury severity and/or prediction of inflammatory second hit on ICU. However, a large clinical trial with severely injured patients should confirm the prognostic value of neutrophil-derived cf-DNA/NETs.
cf-DNA/NETs seem to be a valuable additional marker for the diagnosis of septic arthritis or periprosthetic infections. However, this result should be confirmed in a large clinical trial.