Dynamics of essential amino acids plasma levels in patients with sepsis treated by the extracorporeal blood purification methods
https://doi.org/10.29235/1814-6023-2020-17-1-64-69
Abstract
Extracorporeal blood purification (EBP) is one of the trends of effective sepsis therapy. Some disadvantages of this method such as a possible reduction of plasma levels of different important metabolites are described. It is known that sepsis disorders of amino acid metabolism are manifested in microcirculation interruptions, the decreased immune response and the increased mortality. The aim of the study is to investigate the EBP effect on the essential amino acid plasma levels in patients diagnosed with sepsis. We selected 38 patients diagnosed with sepsis. Standard treatment protocols of plasma filtration, hemofiltration, and hemadsorption with various sorbents were used. We revealed a significant decrease in the levels of valine, methionine, tryptophan, isoleucine, phenylalanine, leucine, and lysine in patients who underwent hemadsorption by the sorbent “Proteasosorb”. Hemadsorption by the sorbent “Proteasosorb” has the greatest effect on the levels of amino acids.
About the Authors
R. E. YakubtsevichBelarus
Ruslan E. Yakubtsevich – D. Sc. (Med.), Assistant Professor, Head of the Department
80, Gorky Str., 230015, Grodno
N. V. Belyavsky
Belarus
Nickolay V. Belyavsky – anesthesiologist-rheanimatologist
Leninsky Komsomol Boulevard, 52, 230015, Grodno
A. A. Glazev
Belarus
Anton A. Glazev – Ph. D. (Biol.), Deputy Vice-Rector for Research
22, Ozheshko Str., 230023, Grodno
S. D. Klisa
Belarus
Sergey D. Klisa – Junior researcher
22, Ozheshko Str., 230023, Grodno
References
1. Lee J. M., Lee H. B. Clinical year in review 2014: critical care medicine. Tuberculosis and Respiratory Diseases, 2014, vol. 77, no. 1, pp. 6–12. https://doi.org/10.4046/trd.2014.77.1.6
2. Rimmelé T., Kellum J. A. Clinical review: blood purification for sepsis. Critical Care, 2011, vol. 15, no. 1, art. 205. https://doi.org/10.1186/cc9411
3. Ankawi G., Neri M., Zhang J., Breglia A., Ricci Z., Ronco C. Extracorporeal techniques for the treatment of critically ill patients with sepsis beyond conventional blood purification therapy: the promises and the pitfalls. Critical Care, 2018, vol. 22, no. 1, art. 262. https://doi.org/10.1186/s13054-018-2181-z
4. Michie H. R. Metabolism of sepsis and multiple organ failure. World Journal of Surgery, 1996, vol. 20, no. 4, pp. 460– 464. https://doi.org/10.1007/s002689900072
5. Druml W., Heinzel G., Kleinberger G. Amino acid kinetics in patients with sepsis. American Journal of Clinical Nutrition, 2001, vol. 73, no. 5, pp. 908–913. https://doi.org/10.1093/ajcn/73.5.908
6. . Biolo G., Toigo G., Ciocchi B., Situlin R., Iscra F., Gullo A., Guarnieri G. Metabolic response to injury and sepsis: changes in protein metabolism. Nutrition, 1997, vol. 13, no. 9, pp. 525–575. https://doi.org/10.1016/s0899-9007(97)83044-4
7. Sekine A., Okamoto M., Kanatani Y., Sano M., Shibata K., Fukuwatari T. Amino acids inhibit kynurenic acid formation via suppression of kynurenine uptake or kynurenic acid synthesis in rat brain in vitro. SpringerPlus, 2015, vol. 4, p. 48. https://doi.org/10.1186/s40064-015-0826-9
8. Ristagno G., Latini R., Vaahersalo J., Masson S., Kurola J., Varpula T. [et al.]. Early activation of the kynurenine pathway predicts early death and long-term outcome in patients resuscitated from out-of-hospital cardiac arrest. Journal of the American Heart Association, 2014, vol. 3, no. 4. https://doi.org/10.1161/JAHA.114.001094
9. Karakuła-Juchnowicz H., Flis M., Szymona K., Kuczyńska M., Stelmach E., Kowal-Popczak A. New prospects for antipsychotic treatment – the role of the kynurenine pathway. Psychiatria Polska, 2014, vol. 48, no. 6, pp. 1167–1177. https://doi.org/10.12740/pp/25520
10. Wijnands K. A., Castermans T. M., Hommen M. P., Meesters D. M., Poeze M. Arginine and citrulline and the immune response in sepsis. Nutrients, 2015, vol. 7, no. 3, pp. 1426–1463. https://doi.org/10.3390/nu7031426
11. Dellinger R. P., Levy M. M., Rhodes A., Annane D., Gerlach H., Opal S. M. [et al.]. Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Critical Care Medicine, 2013, vol. 41, no. 2, pp. 580–637. https://doi.org/10.1097/CCM.0b013e31827e83af
12. Bone R. C., Balk R. A., Cerra F. B., Dellinger R. P., Fein A. M., Knaus W. A., Schein R. M., Sibbald W. J. Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 1992, vol. 101, no. 6, pp. 1644– 1655. https://doi.org/10.1378/chest.101.6.1644
13. Levy M. M., Fink M. P., Marshall J. C., Abraham E., Angus D., Cook D., Cohen J., Opal S. M., Vincent J. L., Ramsay G. SCCM/ESICM/ACCP/ATS/SIS. 2001 SCCM/ESICM/ACCP/ATS/SIS International sepsis definitions conference. Critical Care Medicine, 2003, vol. 31, no. 4, pp. 1250–1256. https://doi.org/10.1097/01.ccm.0000050454.01978.3b
14. Kirkovskii V. V., Kolesnikova I. G., Lobacheva G. A., Sedelkina E. L. Biospecific sorbents: successes and problems. Neotlozhnaya meditsinskaya pomoshch’. Zhurnal im. N. V. Sklifosovskogo [Emergency medical care. Journal named after N. V. Sklifosovsky], 2016, no. 2, pp. 16–19 (in Russian).
15. Appel W. Chymotrypsin: molecular and catalytic properties. Clinical Biochemistry, 1986, vol. 19, no. 6, pp. 317–322. https://doi.org/10.1016/s0009-9120(86)80002-9
16. Rawlings N. D., Barrett A. J. Families of serine peptidases. Methods in Enzymology, 1994, vol. 244, pp. 19–61. https://doi.org/10.1016/0076-6879(94)44004-2
17. Bieth J. G. Les élastases. Journal de la Société de Biologie, 2001, vol. 195, no. 2, pp. 173–179. https://doi.org/10.1051/jbio/2001195020173
18. Severin E. S. (ed.). Biochemistry. Moscow, GEOTAR-media Publ., 2003. 779 p. (in Russian).
19. Maxvold N. J., Smoyer W. E., Custer J. R., Bunchman T. E. Amino acid loss and nitrogen balance in critically ill children with acute renal failure: a prospective comparison between classic hemofiltration and hemofiltration with dialysis. Critical Care Medicine, 2000, vol. 28, no. 4, pp. 1161–1165. https://doi.org/10.1097/00003246-200004000-00041
Review
For citations:
Yakubtsevich R.E., Belyavsky N.V., Glazev A.A., Klisa S.D. Dynamics of essential amino acids plasma levels in patients with sepsis treated by the extracorporeal blood purification methods. Proceedings of the National Academy of Sciences of Belarus, Medical series. 2020;17(1):64-69. (In Russ.) https://doi.org/10.29235/1814-6023-2020-17-1-64-69