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Annals of Intensive Care
Fig. 3 | Annals of Intensive Care

Fig. 3

From: Adverse outcomes with extracorporeal adsorbent blood treatments in toxic systemic inflammation: a perspective on possible mechanisms

Fig. 3

Cytokine rescue and depot. A The fast clearance of free cytokines principally results from renal and hepatic excretion and metabolism, and receptor clearance by endocytosis. Cytokine adsorption to a matrix could “rescue” the cytokine from renal or hepatic excretion and metabolism and prevent receptor binding and endocytosis. Cytokine adsorbed to matrix could form a “depot of cytokines”. B Gradual desorption of cytokine from the matrix “depot” over time could provide a sustained, low level of cytokine agonist to responsive cells. Nonlinear cell responses to sustained low cytokine levels could drive a “superagonistic” inflammatory response contrary to the therapeutic intention of adsorptive treatment

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