TY  - JOUR
T1  - Endotoxin Adsorption with Polymyxin B Hemoperfusion: Mechanistic Insights and Therapeutic Implications for Septic Shock
A1  - Fabio L. Rizzi
A1  - Lucia F. Romano
A1  - Ahmed S. Farouk
JF  - Bulletin of Pioneering Researches of Medical and Clinical Science
JO  - Bull Pioneer Res Med Clin Sci
SN  - 3006-2659
Y1  - 2025
VL  - 5
IS  - 2
DO  - 10.51847/IoqafDtD7n
SP  - 152
EP  - 162
N2  - Since 1994, polymyxin B immobilized fiber columns (PMX) have been used to remove endotoxins in patients with sepsis and septic shock. Over the past 25 years, this therapy has shown clinical benefits, but large, multicenter randomized trials have yet to demonstrate a clear survival advantage. Following results from a major North American sepsis trial, a new study is currently investigating whether PMX can improve long-term survival in septic patients. Additional insights may come from analyzing large clinical databases. PMX columns have proven effective at adsorbing endotoxins in laboratory studies, and animal experiments have further confirmed their potential. However, the exact way PMX disrupts the sepsis cascade and reduces organ damage is not fully understood. Evidence shows that PMX can enhance antigen expression on monocytes and neutrophils. These immunomodulatory effects, whether through endotoxin removal or other mechanisms, may help explain improvements in organ function observed in patients. Endotoxemia may also contribute to diseases beyond sepsis, and rapid diagnostic tools to detect it could enable more precise treatments and expand the clinical use of endotoxin removal.
UR  - https://bprmcs.com/article/endotoxin-adsorption-with-polymyxin-b-hemoperfusion-mechanistic-insights-and-therapeutic-implicatio-1mcegxepwgxicyl
ER  -