Physiological response to superantigen-adsorbing hemoperfusion in toxin-concentration-controlled septic swine

Introduction

Superantigens are suspected of being potent initiators of Gram-positive sepsis, and new therapies for superantigen elimination are required. The effects of hemoadsorption with a superantigen-adsorbing device (SAAD) should be evaluated in septic swine. The aim of this study was to examine the efficacy of SAAD by sequential monitoring of physiological and serological parameters.

Methods

Twelve landrace male pigs (25–38 kg) were mechanically ventilated and anesthetized with isofluorane. A Swan-Ganz catheter was inserted into the right jugular vein and the right carotid artery was used for the monitoring of blood pressure. The anti-toxic shock syndrome toxin-1 (anti-TSST-1) IgG antibody and anti-TSST-1 IgM antibody were under detection the level, as judged by ELISA. The LPS in the blood stream was also under the detection level (<5 pg/ml). TSST-1 was infused at 2 μg/kg/hour, and the blood concentration was maintained at the clinical level for 6 hours, LPS (10 μg/kg/hours) was then infused to induce lethal shock. Heparin (200 U/kg/hour) was used as the anticoagulant. All animals were hemoperfused with SAAD or a control column for 8 hours and changes in pathological parameters and mortality were examined.

Results

Animals perfused with SAAD had a highly significant (P < 0.01) survival advantage compared with control groups at 24 hours after initiation of TSST-1 infusion. SAAD also suppressed the increase in the arterio-venous shunt ratio and decrease of partial arterial oxygen pressure at 6 hours after TSST-1 infusion initiation.

Conclusion

We suggest that there is a potential application of SAAD in treating superantigen-induced respiratory dysfunction and sepsis.