-Original-

Sphingosine-1-Phosphate (S1P) Is a Feasible Biomarker in Predicting the Efficacy of Polymyxin B-Immobilized Fiber Direct Hemoperfusion (PMX-DHP) in Patients with Septic Shock

Satoshi Inoue¹, Yuichiro Sakamoto², Hiroyuki Koami², Kosuke Yamada C², Futoshi Nagashima¹, Toru Miike², Takashi Iwamura¹ and Toru Obata³

¹Division of Trauma Surgery and Surgical Critical Care, Saga University Hospital, Saga, Japan
²Department of Emergency Medicine, Saga University Hospital, Saga, Japan
³Department of Surgery, Shiga University of Medical Science, Shiga, Japan

Purpose: The aim of this study was to identify a useful biomarker to predict the efficacy of polymyxin B-immobilized fiber direct hemoperfusion (PMX-DHP) in patients with septic shock.
Methods: The 44 patients included in this study were divided into two groups. Group A had an increase in systolic blood pressure (SBP) over 30 mmHg after PMX-DHP treatment. Group B had an increase in SBP less than 30 mmHg after PMX-DHP treatment. We evaluated the clinical characteristics and demographics of both groups. We also assessed whether the cause of sepsis affected the efficacy of PMX-DHP and compared the prognosis of both groups. Finally, we investigated whether there were any significant differences in the levels of sepsis-related biomarkers, including sphingosine-1-phosphate (S1P), between both groups before PMX-DHP in an effort to identify a biomarker that could predict the efficacy of PMX-DHP.
Results: PMX-DHP significantly increased SBP regardless of the cause of sepsis. Although there was some tendency, PMX-DHP did not significantly improve the prognosis of effective cases in comparison with non-effective cases, probably because of the limited number of patients included. Among the sepsis-related biomarkers, only S1P values were significantly different between the two groups before PMX-DHP, and S1P levels were significantly increased after treatment in the effective cases.
Conclusion: S1P levels prior to PMX-DHP can be used to predict its efficacy. In addition, continuous monitoring of S1P levels can indicate the effectiveness of PMX-DHP in patients with septic shock.

J Nippon Med Sch 2018; 85: 39-46

Keywords
PMX-DHP, sepsis, septic shock, biomarkers, S1P

Correspondence to
Satoshi Inoue, Division of Trauma Surgery and Surgical Critical Care, Saga University Hospital, 5-1-1 Nabeshima, Saga City, 849-8501, Japan
satoshimeister@gmail.com

Received, June 7, 2017
Accepted, November 24, 2017