Changes and significance of LPS and recognition receptor CD14 in prophylactic high volume hemofiltration treatment for multiple organ dysfunction syndrome

doi:10.3760/cma.j.issn.1673-4777.2009.12.003

Abstract：Objective To investigate the Changes and significance of LPS and recognition receptor CD14 in prophylactic high volume hemofiltration treatment for multiple organ dysfunction syndrome. Methods Double-hit porcine model of MOBS was duplicated in 19 pigs which were divided randomly into MOBS group (group M, n=9) and HVHF group(group HF, n=10). Group M was given compound factors including hemorrhagic shock, reperfu-sion injury and endotoxemia. Group HF was given prophylactic high-volume hemofiltration after endotoxemia. Major organs functions were monitored. Horseshoe crab reagent was used to detect the concentration of LPS in both group animal blood and the concentration of LPS in ultrafiltration at setting time points. The change of receptors CD14 pro-tein expression on monocytes was detected by flow cytometry. Results The morbidity of MOBS and mortality in group HF were 2/10 and 2/10 respectively, which was much lower than that in group M (8/9 and 7/9 respectively) (P<0.01). The concentration of blood LPS increased significantly after LPS injection and increased continually at every time point afterwards. Compared with group M, there was significant deviation at every time point after filtra-tion in group HF. There was no LPS in the ultrafihration in group HF. In group M, the expression intensity of CD14 protein kept increasing after the LPS injection and reached the peak at the 12th hour, and then decreased gradually. In group HF, the expression of CD14 was similar to that in group M before filtration, but was lower than group M 24h after the filtration and then decreased continually. Conclusions The changes of LPS and CD14 expression may play important role in the pathogenesis of MOBS. Earlier HVHF can remove the high concentration of blood LPS and down-regulate the expression of CD14. Accordingly it may inhibit the development of uncontrolled inflammation at earlier period and the development of MOBS.