Cytokines, Bilirubin, Ticagrelor, Rivaroxaban, and other hydrophobic molecules

This entry describes a heterogeneous group of molecules targeted for removal from the blood via extracorporeal hemoperfusion devices, such as CytoSorb. These molecules include pro-inflammatory cytokines (e.g., Interleukin-6, Interleukin-10, Tumor necrosis factor-alpha), metabolic byproducts like bilirubin, and pharmacological agents including the P2Y12 inhibitor ticagrelor and the Factor Xa inhibitor rivaroxaban [1, 2]. The biological role of these molecules varies: cytokines mediate the systemic inflammatory response, bilirubin is a heme degradation product that can be toxic at high levels, and ticagrelor/rivaroxaban are used for anticoagulation and antiplatelet therapy [3, 4]. In clinical settings such as sepsis, liver failure, or emergency cardiac surgery, the excessive presence of these molecules can lead to organ dysfunction or life-threatening bleeding [2, 3]. Therapeutic intervention involves the use of biocompatible polymer beads that adsorb these hydrophobic substances based on size exclusion and surface chemistry [1, 4]. Consequently, this 'target' represents a clinical profile for blood purification rather than a single biological receptor or enzyme [1]. Sources: [1] CytoSorbents Corporation. (2024). CytoSorb Technical Description. [2] Scharf, C., et al. (2021). Bilirubin and cytokine removal by CytoSorb. Critical Care. [3] Javanbakht, M., et al. (2020). Ticagrelor removal by CytoSorb in patients undergoing urgent cardiac surgery. Journal of Cardiothoracic Surgery. [4] Hassan, K., et al. (2019). Cytokine Adsorption in Patients with Sepsis-Induced Acute Kidney Injury. Blood Purification.

Other names

Inflammatory mediatorsHydrophobic toxinsAdsorption substrates of CytoSorbExtracorporeal removal targets

Extracorporeal adsorption via porous polymer beads based on size exclusion and hydrophobic interactions [1, 4]