Changes and correlation of peripheral blood leukocyte elastase and monocyte surface lipopolysaccharide receptors in patients with sepsis undergoing continuous blood purification therapy

Objective To investigate the effect of continuous blood purification(CBP) therapy on peripheral blood leukocyte elastase(HLE) and monocyte surface lipopolysaccharide receptor(mCD14) in patients with sepsis and their correlation. Methods A prospective case-control study of 60 patients with severe sepsis admitted to the Department of Critical Care Medicine, Shaoxing People's Hospital between June 2015 to December 2017 were enrolled and divided into CBP group(30 cases) and control group(30 cases) according to the implementation of continuous hemofiltration treatments. At the time of 0, 12, 24, 48, and 72 hours after the treatment in both groups, the peripheral blood samples were collected, the changes of mCD14 were detected by flow cytometry, and the changes in expression of leukocyte elastase(HLE) was detected by ELISA. Correlation analysis of HLE Level and mCD14 expression in CBP group was made by Pearson software. Results At the 12 th, 24 th, 48 th, and 72 th hours after the treatment, the HLE levels in both groups were lower than those before the treatment(all P<0.001), and the CBP group was significantly lower than the Control group. At the 12 th, 24 th, 48 th, and 72 th hours after the treatment, the mCD14 levels in both groups were up-regulated as compared with the levels before the treatment(all P<0.001), while the CBP group was more significantly as compared with the control group. There was a negative correlation between HLE level and mCD14 expression in CBP group(r=-0.644, P<0.001). Conclusion CBP treatment can reduce the level of HLE by eliminating inflammatory factors and pro-inflammatory mediators, directly or indirectly, in patients with sepsis, as well as reduce its effect on monocyte mCD14 expression, so that the patient's immune function will be restored to a certain extent. This probably may be one of the mechanisms for CBP to participate in the reconstruction of the immune homeostasis state.