Extracting a patient’s plasma and removing certain proteins may enhance sepsis treatment outcomes.
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Patients suffering from severe sepsis may soon benefit from innovative treatments that filter their blood to remove critical proteins underlying life-threatening responses. Promising results in animal studies set the stage for human trials scheduled for next year.
Sepsis occurs when the immune system overreacts to an infection, causing severe damage to tissues and organs. It can escalate to septic shock, which leads to dangerously low blood pressure and further complications. In 2017, there were 49 million cases of sepsis worldwide. According to a meta-analysis involving patients in Europe, North America, and Australia, 32% of sepsis patients died within 90 days despite treatment for the initial infection and organ damage, while the mortality soared to 39% among those with septic shock.
Emerging therapies that target the root causes of this condition could halt the progression of sepsis. Isaac Elias from the Amitava Medical Clinic Healing Center in Santa Rosa, California, has dedicated decades to studying a protein called galectin-3. This protein has numerous functions in healthy individuals, including regulating cell life cycles and activating immune responses. Galectin-3 is believed to be implicated in various health conditions, with Elias stating, “Our research spans multiple areas, from autoimmunity to cancer.”
Curious about galectin-3’s potential role in sepsis, Elias noted that high levels of this protein correlate with an increased risk of death in sepsis patients. To explore this, Elias and his team developed a device that filters galectin-3 from the blood. The process involves withdrawing a sizable blood sample, separating the plasma in a centrifuge, and using a filter with antibodies to target and remove galectin-3. The purified plasma is then combined with the blood cells and reintroduced to the patient.
This innovative apheresis device is currently being tested by teams including Peng Zhiyong from Zhongnan Hospital of Wuhan University in China, applying a multifaceted approach.
Initially, they monitored 87 septic patients versus 27 healthy individuals, discovering elevated galectin-3 levels in the sepsis group. Subsequent assessments showed a decrease in galectin-3 levels among survivors.
The research team also utilized the hemofiltration device in two animal models of sepsis, starting with 48 rats that developed sepsis due to a large intestine puncture. Of these, 28 underwent galectin-3 hemofiltration, while the rest received a sham procedure. Remarkably, 57% of the treatment group survived, compared to just 25% in the control group.
Furthermore, the team applied galectin-3 apheresis to minipigs subjected to lipopolysaccharide, a bacterial component that induces a robust immune response and sepsis. All pigs received intensive care, with 16 undergoing galectin-3 apheresis and 15 getting sham apheresis. The treatment group demonstrated higher survival rates: 69% versus 27%.
“This is certainly innovative,” remarks Jirali Anand of Raymond Poincaré Hospital in Garches, France. “The results remain consistent across both animal models.” Nevertheless, he emphasizes the need for further research to uncover how galectin-3 contributes to sepsis before establishing a standardized treatment. Anand also anticipates replicating these results in independent studies and different animal species, including primates.
Elias’ company, Elias Therapeutics, is actively seeking funding to launch a randomized clinical trial of galectin-3 apheresis in humans, aimed for initiation in 2027.
Source: www.newscientist.com
