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Damage-Associated Molecular Patterns as Mediators of Thrombus Formation on Dialyzer Membrane in Critically Ill Patients.
Okamoto, Kaori; Ito, Takashi; Sato, Sara; Yamamoto, Masahiro; Takahashi, Masaki; Takahashi, Yuki; Tsuchida, Takumi; Mizugaki, Asumi; Hayakawa, Mineji.
Afiliación
  • Okamoto K; From the Division of Medical Engineering Center, Hokkaido University Hospital, Sapporo, Japan.
  • Ito T; Faculty of Life Sciences, Department of Biomedical Laboratory Sciences, Kumamoto University, Kumamoto, Japan.
  • Sato S; Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan.
  • Yamamoto M; Graduate School of Health Sciences, Kumamoto University, Kumamoto, Japan.
  • Takahashi M; Faculty of Life Sciences, Department of Morphological and Physiological Sciences, Kumamoto University, Kumamoto, Japan.
  • Takahashi Y; Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
  • Tsuchida T; Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
  • Mizugaki A; Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
  • Hayakawa M; Emergency and Critical Care Center, Hokkaido University Hospital, Sapporo, Japan.
ASAIO J ; 2024 Apr 05.
Article en En | MEDLINE | ID: mdl-38574389
ABSTRACT
This prospective study investigated the relationship between inflammation, damage-associated molecular patterns (DAMPs), and thrombus formation on dialyzer membranes in critically ill patients undergoing renal replacement therapy (RRT) from July 2020 to August 2022, identifying mechanisms and interventions to prevent clotting. The patients were divided into two groups inflammatory (n = 56, serum C-reactive protein >10 mg/dl) and noninflammatory control (n = 45, serum C-reactive protein <5 mg/dl). Cell-free deoxyribonucleic acid (DNA) levels, high mobility group box 1 protein (HMGB1), histone H3, and myeloperoxidase (MPO) in the lumen of the hollow fiber membrane of the dialyzer were quantified. Immunostaining assessed leukocytes, fibrin fibers, and platelet thrombi on the luminal surface of the hollow fiber membrane. The inflammatory group, compared to controls, exhibited elevated cell-free DNA, HMGB1, and MPO levels, although histone H3 remained unchanged. Damage-associated molecular patterns increased with disseminated intravascular coagulation (DIC) severity. Immunostaining in the inflammatory group revealed leukocytes, amorphous nuclei, neutrophil extracellular trap-like structures, fibrin fibers, and platelet thrombi on the hollow fiber membrane's luminal surface. Elevated DAMP levels in severely inflamed patients' dialyzer membranes, correlating with DIC severity, indicate a link between inflammation, coagulation activation, and dialyzer clotting. Research into thrombus prevention in RRT for DIC-affected critically ill patients is warranted.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Idioma: En Revista: ASAIO J Asunto de la revista: TRANSPLANTE Año: 2024 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Estados Unidos