Removal of Circulating Cytokines by Hemodialysis Membranes In Vitro

Abstract

The cytokines interleukin-1 (IL-1α and IL-1β) and tumor necrosis factor alpha (TNFα) produced by activated mononuclear leukocytes are important mediators of the host response to infection and injury [1]. As IL-1β and TNFα act synergistically in the induction of a shock-like state after intravenous injection into laboratory animals [2], these cytokines are likely to be involved in the pathogenesis of septic shock. During experimental fever induced by intravenous injection of endotoxin into humans, serum levels of TNFα [3] and IL-1β [4] are elevated. Recent publications reported elevated circulating concentrations of IL-1β and TNFα in children with severe infectious purpura [5] and in patients with meningococcal infection [6] or septic shock [4]. The latter studies also describe a correlation between plasma TNFα concentrations and severity of disease. As the highest levels of TNFα were found in patients who died these studies suggest that the reduction in circulating cytokines could be beneficial to critically ill patients.