2014 Volume 5 Issue 1 Pages 3-13
Hemodialysis was applied for renal failure patients as the first blood purification modality. Apheresis using membrane filters, adsorption columns were consecutively developed for acute blood purification of liver failure, acute pancreatitis, multiple organ failure (MOF). Membrane blood purification, however, is incomplete because of loss of metabolic function. Bioartificial tubule devices (BTD) consisting of tubular epithelial cells and artificial membrane has been developed in order to improve survival rates of MOF patients, by which not only removal of toxins but metabolic function can be added. 24 male goats were injected lethal dose of lipopolysaccharide (LPS) at 48 hours after bilaterally nephrectomy, and were divided into 3 treatment groups (8 each); continuous hemofiltration (CHF) with cell-free BTD (sham group), CHF with BTD (BTD group) and non-treatment group. Plasma IL-6 levels, and mRNA expression of IL-1β, IL-6, IL-10, TNFα, and interferonγin peripheral blood mononuclear cells (PBMC) using RT-PCR were determined before and during the treatment in these goats. Survival time of BTD group was significantly longer than those of sham BTD and non-treatment (p＜0.01). Plasma IL-6 levels in BTD group were significantly lower than in sham group (p＜0.01). Expressions of cytokine mRNA in PBMC were stimulated after LPS injection, and suppressed thereafter in BTD group, although the expression were stimulated continuously in sham group. It is suggested that suppressed expression of mRNA of cytokines was main cause of lowered cytokine levels, and that longer survival time was brought from lowered cytokine levels in BTD group.
