Suppression of inflammation during cell-free concentrated ascites reinfusion therapy (CART) using a blood purification device.

In recent years, cell-free concentrated ascites reinfusion therapy (CART) has been used to treat patients with malignant ascites. However, CART involves enrichment and reinfusion of useful proteins and inflammatory cytokines. Therefore, fever is a primary side effect and significant problem for patients with ascites. We removed interleukin (IL)-6, an inflammatory cytokine, by mixing malignant ascites and the hexadecyl group adsorbent from a β2-microglobulin-adsorbing column (Lixelle S-15). As a result, the hexadecyl grope adsorbent did not adsorb albumin of malignant ascites but adsorbed 43% of IL-6. To investigate the effect of the hexadecyl group adsorbent on hepatocytes, the adsorbed ascites was added to a human hepatoma cell line (HepG2), and the gene expression levels of albumin and serum amyloid A protein (SAA) were examined. After absorption, ascites showed significantly suppressed SAA expression and significantly increased albumin gene expression compared to before adsorption. Our results suggest that incorporation of Lixelle to filter and concentrate malignant ascites can suppress inflammatory responses and reduce the inhibition of albumin synthesis in the liver after reinfusion.