To Hemoadsorb or Not to Hemoadsorb—Do We Have the Answer Yet? An Updated Meta-Analysis on the Use of CytoSorb in Sepsis and Septic Shock

Biomedicines, Journal Year: 2025, Volume and Issue: 13(1), P. 180 - 180

Published: Jan. 13, 2025

Severe inflammation leading to organ dysfunction is the cornerstone of pathophysiology sepsis. Thus, from a theoretical point view, rebalancing has potential improve patient outcomes. Methods: To better understand clinical effectiveness hemoadsorption in managing inflammation, we conducted an updated meta-analysis on effects CytoSorb critically ill septic patients. Ten studies containing 715 patients (355 interventional group and 360 control group) have been included final analysis. Results: Statistical analysis demonstrated that use did not influence overall mortality (OR 0.95, 95% CI [0.58, 1.56], p = 0.85), but observed decreased when comparing CytoSorb-treated with treated continuous renal replacement therapy (CRRT) 0.97, [0.46, 0.98], 0.04). We also increased whom was initiated earlier treatment course observe any significant difference either intensive care unit length stay (p 0.93) or between end-of-treatment severity scores two groups 0.24). Conclusions: Although it high risk bias, current evidence does support routine The addition CRRT may be associated survival as compared alone, future are needed draw definitive conclusion.

Language: Английский

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In-depth analysis of the safety of CAR-T cell therapy for solid tumors

Frontiers in Immunology, Journal Year: 2025, Volume and Issue: 16

Published: Feb. 24, 2025

In recent years, the rapid progress in oncology, immunology, and molecular biology has dramatically advanced cancer immunotherapy, particularly CAR-T cell therapy. This innovative approach involves engineering a patient's T cells to express receptors that specifically target tumor antigens, enhancing their ability identify eliminate cells. However, effectiveness of therapy solid tumors is often hampered by challenging microenvironment (TME). The complex TME includes dense stroma obstructs infiltration, abnormal blood vessel structures leading hypoxia, an acidic pH, all which hinder function. Additionally, presence immunosuppressive factors reduces efficacy cells, making successful targeting more difficult. safety gained interest, especially shown considerable various cancers, with notable results multiple myeloma hepatocellular carcinoma, among others. Nonetheless, associated several adverse reactions primarily driven heightened levels proinflammatory cytokines. These include cytokine release syndrome (CRS), neurotoxicity (CANS), organ toxicity, serious complications. CRS, characterized systemic inflammation due release, can escalate severe dysfunction. It typically occurs within first week post-infusion, correlating expansion presents fever hypotension. Meanwhile, CANS encompasses neurological issues ranging from mild symptoms seizures, possibly exacerbated CRS. Organ toxicity also arise therapy, potential damage affecting gastrointestinal tract, kidneys, liver, lungs, tied shared antigens found both healthy tissues. Moreover, long-term effects like cytokine-associated hematotoxicity (CAHT) secondary malignancies represent significant concerns could affect quality life post-treatment. challenges treating underscore need for ongoing research. Strategies improve efficacy, minimize reactions, enhance patient are critical. Future explorations designing better navigate TME, identifying specific antigen profiles off-target damage, developing adjunct therapies mitigate cytokine-related toxicity. Continued monitoring will be paramount improving outcomes maintaining life. Overall, while holds great promise, it must administered careful consideration side rigorous management strategies ensure treatment efficacy.

Language: Английский

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CytoSorb® as the Rescue Therapy of Acute Respiratory Distress Syndrome and Shock in a Case of Severe Pancreatitis

Indian Journal of Critical Care Case Report, Journal Year: 2025, Volume and Issue: 4(3), P. 61 - 63

Published: April 25, 2025

Language: Английский

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