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    Can the Reduction of Cytokines Stop the Progression of Sepsis?
    (Springernature, 2022) Koc, Suna; Celebi, Serdar; Hanikoglu, Ferhat; Polat, Yalcin; Uysal, Betul Borku; Dokur, Mehmet; Ozer, Turkan
    Objective In this study, we aimed to analyze the laboratory and clinical results of cytokine hemadsorption as an immunomodulation therapy in ICU patients diagnosed with sepsis or septic shock. Methods The levels of procalcitonin (PCT) and C-reactive protein (CRP), determined to be indicators of infection/sepsis, and the levels of interleukins (IL-6, IL-8, and IL-10) and tumor necrosis factor alpha (TNF alpha), deemed as indicators of the cytokine storm, were compared among 32 patients before and after the hemadsorption procedure. Results The hemadsorption significantly reduced the levels of IL-6, IL-8, IL-10, TNF alpha, PCT, CRP, Acute Physiology and Chronic Health Evaluation (APACHE) scores, mortality rate, and Sequential Organ Failure Assessment (SOFA) scores (p<0.05). APACHE scores and the mean predicted mortality rate (PMR) of the non-survivors measured before the procedure was significantly higher than those of survivors (p=0.002 for both). IL-10, APACHE scores, and the mortality rates determined before the hemadsorption procedure were deemed significant parameters to predict the mortality among all ICU patients (p 0.05). IL-10 levels <= 125.3 ng/L, APACHE score 30, and PMR >70.33 were significantly associated with the mortality rates of all patients, indicating that these three parameters determined before the hemadsorption may be good predictors of mortality among ICU patients with sepsis. Conclusion The progression of sepsis in ICU patients may be prevented with cytokine hemadsorption applied as an immunomodulator therapy.
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    Comparison of Cytokine Hemadsorption as an Immunomodulator Therapy in COVID-19 Patients with and without Bacterial Sepsis
    (Clin Lab Publ, 2022) Koc, Suna; Hanikoglu, Ferhat; Dokur, Mehmet; Polat, Yalcin; Celebi, Serdar; Koc, Sena G.; Kupeli, Ilke
    Background: In this retrospective study, we aimed to compare the laboratory and clinical results of cytokine hem-adsorption as an immunomodulation therapy in COVID-19 ICU patients with or without sepsis. Methods: The levels of PCT, CRP, and ferritin were determined as indicators of infection/sepsis; the levels of in-terleukins (IL-6, IL-8 and IL-10, and TNF-??) were determined as indicators of cytokine storm were compared. APACHE score, SOFA score, and mortality rates were compared for the progression of the disease in 23 COVID-19 patients. Results: The therapy was generally successful in reducing the levels of IL-6, IL-8, IL-10, and TNF-?? but the levels measured after the procedure did not differ among the patients with or without sepsis, suggesting that the pres-ence of sepsis did not affect the efficacy and function of the cytokine hemadsorption procedure in COVID-19 pa-tients. All parameters were reduced after the procedure except the levels of PCT and ferritin and mortality rates of patients diagnosed with sepsis. The level of PCT was significantly higher in these patients compared with the patients without sepsis while the ferritin and mortality did not show any significant difference between the two groups, suggesting that the cytokine hemadsorption may be safe in the treatment of critical COVID-19 patients. Conclusions: As a result, the progression of sepsis in COVID-19 may be avoided with cytokine hemadsorption ap-plied as an immunomodulator therapy. However, this therapy should be further explored and validated prior to its introduction to everyday clinical practice when the epidemic conditions end.