Feasibility of hemoperfusion using extracorporeal therapy in the horse.
Abstract: Develop, implement, and monitor for adverse effects of, a novel hemoperfusion therapy in adult horses. Unassigned: A prospective, observational feasibility study using three healthy adult horses from the North Carolina State University teaching herd. Health status was determined by physical exam, complete blood count, coagulation panel, and serum biochemistry. Each horse was instrumented with a 14 Fr × 25 cm double-lumen temporary hemodialysis catheter and underwent a 240 min polymer-based hemoperfusion session. Horses were administered unfractionated heparin to maintain anti-coagulation during the session. Given the novelty of this therapy in horses, each horse was treated as a learning opportunity that informed an iterative process of protocol development and modification. Unassigned: Our long-term goal is to investigate potential clinical applications of hemoperfusion in horses, including cytokine reduction in horses with severe SIRS/sepsis. Horses were monitored for changes in clinical exam, biochemistry and hematology parameters. Additionally, cytokines were quantified to determine whether extracorporeal hemadsorption therapy alone caused an inflammatory response. Our results show that hemoperfusion therapy was associated with decreased platelet counts and serum albumin concentration. There was no significant change in plasma cytokine concentrations with hemoperfusion therapy. In one horse, the cytokine concentrations decreased, as previously reported with hemoperfusion therapy in humans. Unassigned: We hypothesized that hemoperfusion therapy could be performed in healthy adult horses without significant adverse effects. Unassigned: Polymer-based hemoperfusion is a feasible extracorporeal therapy (ECT) modality for adult horses. Additional studies are needed to further establish clinical protocols, as well as establish efficacy of polymer-based hemoperfusion for treatment of various conditions in horses, including intoxications, immune-mediated conditions, and sepsis.
Copyright © 2024 Hobbs, Le Sueur, Burke, Cooper, Sheats and Ueda.
Publication Date: 2024-05-14 PubMed ID: 38803798PubMed Central: PMC11128652DOI: 10.3389/fvets.2024.1414426Google Scholar: Lookup
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- Journal Article
Summary
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This is a preliminary research study about the feasibility of hemoperfusion therapy in adult horses. The research indicates that this therapy is possible without significant adverse effects, although it did affect platelet count and albumin concentration in the horse’s serum. The therapy might potentially be useful for treating diseases like sepsis in animals.
Overview of the Research
- The study aims to develop, put into practice, and assess the side effects of a hemoperfusion treatment in adult horses. The therapy is quite innovative in equine medicine.
- The research was conducted using three healthy adult horses from the North Carolina State University teaching herd.
- Each horse underwent a thorough physical examination, complete blood count, coagulation panel, and serum biochemistry to confirm its health status.
Hemoperfusion Therapy Procedure
- Each horse was equipped with a 14 Fr × 25 cm double-lumen temporary hemodialysis catheter and went through a 240-minute polymer-based hemoperfusion session.
- Unfractionated heparin was employed in each session to maintain anti-coagulation throughout the treatment.
- Every horse was treated as a unique case, allowing the researchers to continuously improve the protocol based on the experiences and outcomes of the animals.
Monitoring & Results of Hemoperfusion Therapy
- The horses were keenly observed for changes in clinical exam results, biochemistry parameters, and hematology parameters.
- In addition, the study checked for inflammatory response by quantifying cytokines to determine whether extracorporeal hemadsorption therapy alone incited an inflammatory response.
- The results revealed a decrease in platelet counts and serum albumin concentration. This decrement might be because of the therapy itself.
- The plasma cytokine concentrations didn’t show any significant changes post hemoperfusion therapy in healthy horses. However, the therapy managed to lower cytokine concentrations in one horse, mimicking the results observed in human treatments.
Conclusions and Future Directions
- The goal of this study was to examine whether hemoperfusion therapy can be safely administered to healthy adult horses. The results seem to suggest that it can.
- In conclusion, this research suggests that polymer-based hemoperfusion is a promising extracorporeal therapy (ECT) procedure for adult horses.
- More expansive studies are crucial to solidify the clinical protocols, and to establish the efficiency of polymer-based hemoperfusion for treating various conditions in horses, including intoxications, immune-mediated conditions, and sepsis.
Cite This Article
APA
Hobbs KJ, Le Sueur ANV, Burke MJ, Cooper BL, Sheats MK, Ueda Y.
(2024).
Feasibility of hemoperfusion using extracorporeal therapy in the horse.
Front Vet Sci, 11, 1414426.
https://doi.org/10.3389/fvets.2024.1414426 Publication
Researcher Affiliations
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States.
Conflict of Interest Statement
The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.
References
This article includes 31 references
- Ronco C, Bellomo R. Hemoperfusion: technical aspects and state of the art.. Crit Care (2022) 26:135.
- Ricci Z, Romagnoli S, Reis T, Bellomo R, Ronco C. Hemoperfusion in the intensive care unit.. Intensive Care Med (2022) 48:1397–408.
- Foster JD. Extracorporeal therapies in the emergency room and intensive care unit.. Vet Clin North Am Small Anim Pract (2020) 50:1215–36.
- Rugg C, Klose R, Hornung R, Innerhofer N, Bachler M, Schmid S. Hemoadsorption with CytoSorb in septic shock reduces catecholamine requirements and in-hospital mortality: a single-center retrospective “Genetic” matched analysis.. Biomedicines (2020) 8:539.
- Ghannoum M, Bouchard J, Nolin TD, Ouellet G, Roberts DM. Hemoperfusion for the treatment of poisoning: technology, determinants of poison clearance, and application in clinical practice.. Semin Dial (2014) 27:350–61.
- Govil D, Kumar GP. Extracorporeal therapy in Sepsis.. Indian J Crit Care Med (2020) 24:S117–21.
- Gocho T, Mori H, Islam MM, Maruchi Y, Takenaka N, Tomino A. Removal of circulating neutrophil extracellular trap components with an immobilized Polymyxin B filter: a preliminary study.. Shock (2019) 54:44–9.
- Meagher J, Hendricks J, Eatroff A. Cytokine adsorption as an adjunctive treatment for patients with immune-mediated hemolytic Anemia receiving therapeutic plasma exchange: a case series of 3 dogs.. Vet Med (Auckl) (2023) 14:103–10.
- Tracy A, Lynch A, Messenger K, Vaden S, Vigani A. Use of extracorporeal therapy in a dog with heatstroke.. J Vet Emerg Crit Care (San Antonio) (2022) 32:512–9.
- Broux B, Lefère L, Deprez P, van Loon G. Plasma exchange as a treatment for hyperbilirubinemia in 2 foals with neonatal isoerythrolysis.. J Vet Intern Med (2015) 29:736–8.
- Hobbs KJ, Davis JL, Cooper BL, Ueda Y, Burke MJ, Sheats MK. Hemadsorption extracorporeal therapy removes cytokines ex vivo in horses.. Am J Vet Res (2024):1–8.
- DeNotta SL, Brooks MB. Coagulation assessment in the equine patient.. Vet Clin N Am Equine Pract (2020) 36:53–71.
- Lee CT, Chao A, Lai CH, Yeh YC. Heparin dosing score protocol for anticoagulation during polymyxin B hemoperfusion.. J Formos Med Assoc (2018) 117:652–3.
- Nissenson AR, Fine RN. Handbook of dialysis therapy. Netherlands: Saunders/Elsevier; (2008).
- Martin EM, Messenger KM, Sheats MK, Jones SL. Misoprostol inhibits lipopolysaccharide-induced pro-inflammatory cytokine production by equine leukocytes.. Front Vet Sci (2017) 4:160.
- Rawlings CA, Byars TD, Van Noy MK, Bisgard GE. Activated coagulation test in normal and heparinized ponies and horses.. Am J Vet Res (1975) 36:711–3.
- Wright ME, Croser EL, Raidal S, Baral RM, Robinson W, Lievaart J. Biological variation of routine haematology and biochemistry measurands in the horse.. Equine Vet J (2019) 51:384–90.
- de Rosa S, Marengo M, Fiorentino M, Fanelli V, Brienza N, Fiaccadori E. Extracorporeal blood purification therapies for sepsis-associated acute kidney injury in critically ill patients: expert opinion from the SIAARTI-SIN joint commission.. J Nephrol (2023) 36:1731–42.
- Segura D, Monreal L, Pérez-Pujol S, Pino M, Ordinas A, Brugués R. Assessment of platelet function in horses: ultrastructure, flow cytometry, and perfusion techniques.. J Vet Intern Med (2006) 20:581–8.
- Pelagalli A, Lombardi P, d'Angelo D, Della Morte R, Avallone L, Staiano N. Species variability in platelet aggregation response to different agonists.. J Comp Pathol (2002) 127:126–32.
- Kingston JK, Bayly WM, Sellon DC, Meyers KM, Wardrop KJ. Effects of sodium citrate, low molecular weight heparin, and prostaglandin E1 on aggregation, fibrinogen binding, and enumeration of equine platelets.. Am J Vet Res (2001) 62:547–54.
- Magnani S, Atti M. Uremic toxins and blood purification: a review of current evidence and future perspectives.. Toxins (Basel) (2021) 13:246.
- van Gelder MK, Abrahams AC, Joles JA, Kaysen GA, Gerritsen KGF. Albumin handling in different hemodialysis modalities.. Nephrol Dial Transplant (2017) 33:906–13.
- Heymann M, Schorer R, Putzu A. The effect of CytoSorb on inflammatory markers in critically ill patients: a systematic review and Meta-analysis of randomized controlled trials.. Crit Care Med (2023) 51:1659–73.
- Kanjo A, Molnar Z, Zádori N, Gede N, Erőss B, Szakó L. Dosing of extracorporeal cytokine removal in septic shock (DECRISS): protocol of a prospective, randomised, adaptive, multicentre clinical trial.. BMJ Open (2021) 11:e050464.
- Breuer TGK, Quast DR, Wiciok S, Labedi A, Ellrichmann G. Successful treatment of severe Digitoxin intoxication with CytoSorb® Hemoadsorption.. Blood Purif (2020) 50:137–40.
- Xu X, Dai Y. Heparin: an intervenor in cell communication.. J Cell Mol Med (2010) 14:175–80.
- McFarlane D, Holbrook TC. Cytokine dysregulation in aged horses and horses with pituitary pars intermedia dysfunction.. J Vet Intern Med (2008) 22:436–42.
- Miller AB, Loynachan AT, Bush HM, Hart KA, Barker VD, Campana-Emard AG. Effects of pituitary pars intermedia dysfunction and Prascend (pergolide tablets) treatment on endocrine and immune function in horses.. Domest Anim Endocrinol (2021) 74:106531.
- Hinden S, Klukowska-Rötzler J, Janda J, Marti EI, Gerber V, Roosje PJ. Characterization of the inflammatory infiltrate and cytokine expression in the skin of horses with recurrent urticaria.. Vet Dermatol (2012) 23:503–e99.
- . Immune deregulation in Sepsis and septic shock: reversing immune paralysis by targeting PD-1/PD-L1 pathway.. Front Immunol (2020) 11:624279.
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