Effect of plasmapheresis on the immune system in endotoxin-induced sepsis.

Background: It has been proposed that plasmapheresis is most effective when applied early in Gram-negative sepsis. We therefore studied the effect of early plasmapheresis on immunity in experimental Escherichia coli endotoxin-induced sepsis.

Methods: 20 pigs received 30 microg/kg of E. coli endotoxin. 40 min later, half of the pigs were treated with plasmapheresis which lasted 4 h. The adhesion molecules, the oxidative burst, the number of neutrophils in blood and lungs, and cytokines were measured.

Results: Infusion of endotoxin was associated with activation of adhesion molecules increased oxidative burst, increased concentration of cytokine, and accumulation of granulocytes in lung tissue. Plasmapheresis reduced the oxidative burst, and there was a tendency towards a reduced accumulation of granulocytes in the lung.

Conclusion: Though plasmapheresis was initiated early after the endotoxin infusion, it only temporarily attenuated a part of the activated cell-mediated immunity.