Effect of hemofiltration on TLR4/NF-κB pathway activation in mononuclear cells of patients with severe septic shock

Objective To explore the effect of hemofiltration on Toll like receptor 4(TLR4)/nuclear factor pathway activation in peripheral blood mononuclear cells(PBMCs) of patients with severe septic shock. Methods From January 2019 to December 2020, hospitalized patients with severe septic shock were recruited for this retrospective control study. Control group was treated routinely(n=59) while experimental group received routine treatment plus hemofiltration(n=38). Before and 72h after treatment, the difference of heart rate(HR), mean arterial pressure(MAP), central venous pressure (CVP) and serum tumor necrosis factor-α(TNF-α), interleukin-6(IL-6), intercellular adhesion molecule-1(ICAM-1), TLR4/NF-κB expression level in peripheral blood mononuclear cells(PBMCs) and 28-day cumulative mortality were compared. Results At 72h post-treatment, HR and serum levels of TNF-α, IL-6, ICAM-1, TLR4 and NF-κB declined in both groups while MAP and CVP were higher than those pre-treatment(P<0.05);HR, TNF-α, IL-6, ICAM-1, TLR4 and NF-κB and 28-day cumulative mortality were lower in experimental group than those in control group;MAP and CVP were higher than those of control group(P<0.05). Conclusion Hemofiltration may improve shock state, blunt inflammatory responses and boost 28-day survival in patients with severe septic shock. And suppressing TLR4/NF-κ B pathway is a probable molecular mechanism of hemofiltration.