Background: Sepsis is a common condition in adult and neonatal horses. Despite substantial advances in medical management, sepsis continues to be a leading cause of illness and death in these patients. Hemoperfusion through a novel plasma cytokine adsorption device (CytoSorb®) has shown promise as an adjunctive therapy in humans with sepsis.
Hypothesis: LPS-treated horses hemoperfused through a novel cytokine adsorption device (VetResQ) will have lower levels of systemic inflammatory markers compared to sham-filtration.
Animals: Six healthy, university-owned horses. IACUC: 23-110
Methods: 6 horses received 60 ng/kg LPS, IV as a bolus then 60 ng/kg IV as a CRI over 1 hour. Systemic inflammation was confirmed by clinical signs and neutropenia. In a cross over model, hemoperfusion was performed for 4 hours with either a sham or polymer column. Blood was collected at 5 time points over a 72 hr. period for flow cytometry analysis of neutrophils and 10 timepoints for cytokine multiplex analysis.
Results: In an in vivo LPS-induced model of systemic inflammation, column- vs sham- treated horses showed more rapid normalization of leukocyte counts, stabalization of reactive oxygen species and increased early neutrophil apoptosis (p=0.01). Systemic cytokines were not significantly different between column and sham treatment.
Conclusions: These results provide proof-of-concept for hemoperfusion as a potential treatment to mitigate deleterious LPS-induced immune responses in adult horses. Further research is needed to determine the anti-inflammatory mechanism(s) of hemoperfusion therapy.
