Abstract: TH-PO069
Immunomodulatory Effect of Selective Cytopheretic Device (SCD) on Neutrophil-to-Lymphocyte Ratio (NLR) and Hematologic Parameters from Multiple AKI Trials
Session Information
- AKI: Clinical, Outcomes, and Trials - Epidemiology and Pathophysiology
October 24, 2024 | Location: Exhibit Hall, Convention Center
Abstract Time: 10:00 AM - 12:00 PM
Category: Acute Kidney Injury
- 102 AKI: Clinical, Outcomes, and Trials
Authors
- Iyer, Sai Prasad N., SeaStar Medical, Denver, Colorado, United States
- Ollberding, Nicholas J., Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, United States
- Koyner, Jay L., University of Chicago Division of the Biological Sciences, Chicago, Illinois, United States
- Yessayan, Lenar Tatios, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
- Chung, Kevin K., SeaStar Medical, Denver, Colorado, United States
- Humes, H. David, University of Michigan Michigan Medicine, Ann Arbor, Michigan, United States
Background
SCD is an immunomodulatory cell-directed extracorporeal therapy (CDET) that targets activated neutrophils and monocytes in hyperinflammatory conditions such as AKI and sepsis. Inflammatory imbalance can be measured by examining relationships of leukocytes to other immune cells, such as NLR. High NLRs have been associated with poor outcomes across a wide range of diseases, including AKI and sepsis. We examined the effect of SCD treatment from prior AKI clinical studies on NLR and other hematological measures to gain insights into the mechanism of SCD.
Methods
Complete blood count, NLR, monocyte: lymphocyte ratio (MLR), and platelets were included from 5 prior adult and pediatric studies (pooled n=133) in patients with AKI requiring continuous kidney replacement therapy (CKRT). Patients were treated for up to 10 days with SCD + CKRT in all studies. Control CKRT only group included patients from a pivotal study (SCD-003), and from a contemporaneous matched cohort (CRRTnet) (n=32). All parameters were analyzed from the treatment period across these studies between control vs. SCD treated patients using linear mixed effects regression.
Results
Treatment with SCD reduced NLR across all studies during the treatment period. The control group in the SCD-003 study displayed an upward trend in NLR after an initial drop but was not statistically significant vs. the SCD treated group (p = 0.38). When analyzed as a pooled group, SCD treated patients demonstrated a significant reduction in NLR vs. control patients (p=0.007). This difference was maintained following sensitivity analysis excluding pediatric patients (p=0.013). No statistically significant differences were observed between groups for MLR levels or platelets in the treatment period.
Conclusion
SCD treatment demonstrated reductions in NLR across multiple AKI clinical studies. This analysis provides further mechanistic evidence of leukocyte immunomodulation in targeting inflammatory neutrophils and effector immune cell dysregulation in hyperinflammatory conditions such as AKI.
Funding
- Commercial Support – SeaStar Medical