Polymyxin B-immobilized fiber columns:A column to breathe new life into the treatment of interstitial lung disease?

• 作者: Katsuaki Asakawa Toshinori Takada
• 来源期刊: 世界呼吸病学杂志
• 学科: 医学
• 关键词: Acute EXACERBATION IDIOPATHIC pulmonary fibrosis POLYMYXIN B HEMOPERFUSION INTERSTITIAL lung disease
• 年，卷（期）: sjhxbxzz_2015,（1）
• 页码范围: 1-3
• 页数: 3页
• 分类号: R

摘要

Acute exacerbations of idiopathic pulmonary fibrosis(IPF)is a severe respiratory condition with high mortality rate.Direct hemoperfusion with polymyxin B-immobilized fiber columns(PMX-DHP)was originally introduced for the treatment of septic shock.Application of PMX-DHP to the treatment of acute exacerbations of IPF may improve oxygenation and survival of the patients with the disease.In addition to acute exacerbations of IPF,PMXDHP has been applied to acute respiratory failure from various causes;an amyopathic dermatomyositis patient who developed rapidly progressive interstitial lung disease(ILD)with elevated anti-CADM-140/MDA5 autoantibody and a patient with severe amiodarone pulmonary toxicity.It is also demonstrated that PMX-DHP performed on the first day of steroid pulse therapy may improve the prognosis of patients with rapidly progressive ILDs in a case-control setting.PMX treatment decreases not only various circulating molecules but also inflammatory cells,in particular activated monocytes,producing such mediators.Although the incidence of acute exacerbations of IPF is too low for proper randomization,in order to test the effects of PMX-DHP on the disease,a cohort or casecontrol analytic study needs to be conducted,preferably from more than one center or research group.