A peptide-based medical device for the selective removal of inflammatory factors from the blood of people with sepsis

Background: Sepsis is a complex life-threatening clinical condition associated with significant morbidity and mortality. It is usually triggered by an infection, the cellular response to which progresses, involving the innate immune system and leading to a cytokine storm that can provoke death. Methods: The device is based on the peptide SET-M33, an antimicrobial molecule with strong antibacterial activity. The peptide was conjugated with a biocompatible agarose matrix via a covalent sulfonic bridge, then encapsulated in a device to insert in a circulation system. Here we describe a medical device that selectively and simultaneously remove the major triggers of the onset and progression of sepsis from the blood of sepsis patients. These include live bacteria and their components, such as lipopolysaccharides (LPS) and lipoteichoic acids (LTA), as well as C reactive protein (CRP). Results: In a human serum assay, the device removes 85% of LPS, >80% of LTA, >99% of live Gram-positive and Gram-negative bacteria in serum, and >94% of CRP. In ex vivo animal model in which murine blood spiked with known amounts of LPS, the device removes >80% of the endotoxin. After circulation in the device, the serum shows no significant change in protein content, this confirms that the device does not change the molecular profile of the blood. Conclusions: The instrument here described is a prototype with strong potential for clinical applications.