Our lab has two primary foci. The use of extracorporeal therapy for novel treatment of sepsis, ischemia, and reperfusion injury and developing protective mechanisms for the endothelial glycocalyx. So, what exactly are both of these things, and how do they apply to patients?
Extracorporeal Therapy
To put it simply, extracorporeal therapy (ECT) is the overarching term for many different treatment modalities. Among the most popular of these are hemoperfusion, total plasma exchange, and dialysis. Our group most specifically focuses on hemoperfusion, which removes whole blood out of the body, filters it across an adsorbent surface, and then returns it to the body. This is a common treatment for intoxications, though its use for conditions such as immune-mediated disease and sepsis is gaining interest. Our group has proven hemoperfusion to be both safe and effective in adult horses, with further investigations into foals, cattle, and goats ongoing. Even though our group primarily focuses on hemoperfusion, we do offer total plasma exchange as an added treatment modality.
Endothelial Glycocalyx
The endothelial glycocalyx (EG) is a crucial barrier located on the inner surface of healthy blood vessels. This layer consists of proteoglycans, including heparan sulfate, hyaluronan, and syndecan-1. In a healthy state, this layer maintains a balance between the production and breakdown of its components. However, in pathological conditions, this balance is often disrupted, leading to increased degradation of the glycocalyx. This disruption can result in greater vascular permeability, systemic inflammation, and hypercoagulable states. In horses and other species, there is evidence that sepsis and ischemic conditions lead to severe dysregulation, leading to increased mortality of patients. Understanding the mechanisms behind this disruption and targeting the EG constituents may provide a novel treatment mechanism in both sepsis, ischemia, and reperfusion injury.
