Filters to Manage Cytokine Storm

Largely beneficial to critically or severely ill COVID-19 patients: report reveals

New Delhi, August 22, 2020: Despite tireless efforts of researchers and doctors across the world, no vaccine or medicine has come up yet to cure or to curb this global pandemic. It has taken away millions of lives and is consistently bringing new life-threatening conditions. Cytokine Storm is one of such conditions, which turns against the immune system fuelling COVID-19 infection, posing threat to life.

Cytokines can be very harmful to the body if released at once in large numbers. WhileCytokine Storms include infections, autoimmune conditions or other such diseases. Or may even occur after the utilisation of some immunotherapy for treatment. Basic symptoms include — high fever, inflammation, severe fatigue and nausea. Certain cytokines can also trigger cell death. When this happens, many cells begin to die at the same time, leading to the destruction of the entire tissue.

“Cytokines, under normal conditions, are extremely essential for maintaining a healthy immune system by the body. They are small, secreted proteins released by the cells, which affect the communication or interaction between them. Also, they are generally redundant in their activities, which means that different cytokines can facilitate similar functions”, said Dr.Dilip Bhalla, Director, Max Super Speciality Hospital, Patparganj, Max Multi Speciality Centre, Noida, Max Super Speciality Hospital, Vaishali.(Zhang & An, 2009)

Adding further, Dr Bhalla said, “In the case of COVID-19, a Cytokine Storm is highly likely to damage the lung tissues. When this happens, respiratory distress syndrome follows, and the organ begins to fail. A similar process is followed by the rest of the organs as well, leading to an event known as ‘multi-organ failure’ which results in death.”(Goodman, 2020)

While Cytokine Storms can surely be deadly in nature, several strategies for its control have been devised since the outbreak of COVID-19. On one hand, regular monitoring and assessment of Cytokine levels in the body may prove to be beneficial and can guide the clinician on the use of targeted therapies.

Blood purificationhas also proved to be beneficial when it comes to the management of such cytokine storms. Several strategies for blood purification are in use now to control the deadly phenomenon-these include plasma exchange, absorption, perfusion, blood/plasma filtration etc. (Ye, Wang, & Mao, 2020)

Filters to manage Cytokine Storms can play significant role in managing COVID-19 patients who are critically or severely ill. Early reports from China have revealed that up to 20% of COVID-19 patients may fall under this criterion (Topfer, 2020).

“The Oxiris filter set, used for more than a decade in Europe and Asia, works like a sponge to capture and absorb cytokines along with toxins released by bacteria called endotoxins which also induce cytokines, as well as toxins typically filtered by the kidneys called uremic toxins.Like standard kidney dialysis filters, Oxriris filters excess fluid and contain the blood thinner heparin, which can reduce clots, another concern with this COVID-19 infection”, said Dr Sachin Gupta, Senior Consultant & Head, Anaesthesia & Critical Care, Narayana Superspeciality Hospital, Gurugram. (https://jagwire.augusta.edu/).

“In such a crucial time, when COVID-19 cases in India have been increasing exponentially, Oxiris filter of Baxter India has received an extension of indication from the Central Drugs Standard Control Organization (CDSCO) under Directorate General of Health Services, Ministry of Health & Family Welfare, India. The availability of Oxiris filter set in India may help the medical fraternity to fight theCOVID-19 pandemic in a more organised way”,added Dr Gupta.(https://health.economictimes.indiatimes.com/).

The Oxiris Filter set is helpful in blood purificationfor patients who are highly susceptible to additional organ dysfunctions due to high levels of circulating cytokines. During blood purification therapy, the Oxiris Filter helps by adsorbing the inflammatory mediators and removing fluids, electrolytes, and uremic toxins when the blood passes through the filter. An added advantage of using this filter for blood purification is that it does not require any additional devices for kidney support or in other words dialysis whichcan help reduce unnecessary puncturing of patients body.

As the COVID-19 cases have been rising exponentially in India, and the recent spike is beyond speculation. This is a testing time when we require every asset — lock, stock and barrel to combat this. In such a situation, the availability of Oxiris filter will be the milestone in the management of the cytokine storm. The Oxiris filter is also expected to help make the treatment process  smoother and easier to navigate. Hopefully, with the increased use of this filter, more lives can be saved.

References

Goodman, B. (2020). Cytokine Storms May Be Fueling Some COVID Deaths. WebMD.

https://health.economictimes.indiatimes.com/news/pharma/baxter-india-gets-cdsco-approval-for-its-oxiris-filter-for-covid-19-treatment/76849138

Topfer, L.-A. (2020). Blood Purification Using Cytokine Adsorbers to Reduce Cytokine Storm in Severe COVID-19 Illness. CADTH .

Ye, Q., Wang, B., & Mao, J. (2020). The pathogenesis and treatment of the `Cytokine Storm’ in COVID-19. PubMed.

Zhang, J.-M., & An, J. (2009). Cytokines, Inflammation and Pain. PubMed Central.

Corporate Comm India (CCI Newswire)