Abstract
Myoglobin, due to its molecular weight of 17 kDa and a Einstein-Stoke radius greater than expected, is classed as a middle molecular weight uremic toxin and presents a two-compartment model of distribution in the body. Rhabdomyolysis is a condition in which muscle cell content including myoglobin, are released into blood circulation due to severe injury to the muscle. Circulating myoglobin induces renal injury with several mechanisms: reduced concentration of nitric oxide in medullary renal arterioles, production of free radicals with oxidative stress, tubular necrosis as a consequence of tubular obstruction by myoglobin and cellular debris. A possible therapeutic option is the use of High Cut-off membranes but with the risk of significant loss of albumin and other proteins. The use of adsorption can overcome these limitations. The aim of our study is to assess the adsorption of myoglobin with neutral microporous styrene-divinylbenzene copolymer sorbent (e.g., HA330/380, Jafron Biomedical CO, Lts, Zhuhai City, China).
Using a downscaled module of HA380 Cartridge, we set up an ex-vivo circulation experiment in which 1 liter of plasma containing 0.1 mg of myoglobin was pumped through the cartridge. We collected samples (3 mL) at different timepoints to measure Myoglobin concentration. We calculated the removal ratio (RR) and mass adsorbed at a given timepoints.
Initial myoglobin concentration was 99.3 ng/ml. Final myoglobin concentration after 4 hours of experiment was 30.6 ng/ml. Removal Ratio at 4 hour was 69 % and mass adsorption of 0.068 mg of myoglobin.
To our knowledge, this is the first experiment that assessed the adsorption capacity of polystyrene-divinylbenzene sorbent. Our study, demonstrated high adsorption capacity in the first 4 hours of treatment therefore, confirming the possibility to use adsorption as an effective treatment option in rhabdomyolysis and avoiding complications associated to current dialytic treatment.
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