The Alteco LPS Adsorber is a medical device used for extracorporeal blood purification. The product removes circulating endotoxin (lipopolysaccharide, LPS) from the bloodstream. It works through adsorption; a process where molecules or particles attach to the surface of the adsorbent material and are captured there.
Inside the Alteco LPS Adsorber
The housing of the device contains discs made of porous polyethylene (PE) covered in a tailor-made peptide. The peptide binds to lipid-A (the toxic part of endotoxin) with high affinity. By adsorbing endotoxin from the patient’s bloodstream during extracorporeal treatment, the Alteco LPS Adsorber can stabilize the patient’s hemodynamic parameters.
Endotoxin adsorption technology
In the pores – with an average size of 100 microns – on the surface of the discs, covalently immobilized cationic peptide captures the negatively charged endotoxin molecules.
The peptide in the Alteco LPS Adsorber is 100% synthetic, hence it is not genetically engineered but produced by solid phase peptide synthesis. It is not derived from human or animal origins.
Optimized surface area
When blood comes into contact with large artificial surfaces, it induces a systemic response. 1 The Alteco LPS Adsorber uses an optimized surface and adsorption area of approximately 4m 2.
…”gram-negative bacteria produce lipopolysaccharides as endotoxins, which activate toll-like receptors on macrophages and other cells, eliciting the release of pro-inflammatory cytokines and chemokines. Constant stimulation of toll-like receptors leads to damage of vascular endothelial cells and causes blood-clotting abnormalities, eventually resulting in tissue injury, multiple organ dysfunction, and death.”
This case report describes how endotoxin adsorption and cytokine removal can be complementary. "Rapid control of the inflammatory response, modulating not only the inducing stimulus but also the inflammatory mediators, can achieve an early improvement."
High endotoxin levels correlate with higher mortality and can be associated with both gram-negative and -positive infections. Increased endotoxin levels at ICU admission significantly associated with development of severe sepsis.
Did you know that endotoxemia can be present in critically ill patients with COVID-19, independent of superimposed gram-negative infections? A leaky gut barrier might contribute to endotoxin translocation. Study observes elevated endotoxin activity in 75% of critically ill patients with COVID-19 – and higher acute kidney injury rates.