The effect of rheopheresis treatment on the cytokine profile in diabetic foot syndrome with hyperviscosity in the aspect of clinical changes: A preliminary study

Article type: Research Article

Authors: Gal, Kristof^a | Veres, Katalin^a | Halmi, Sándor^a | Bozoki-Beke, Krisztina^a | Fekete, Klara^b | Homoki, Judit^c | Remenyik, Judit^c | Barath, Barbara^d | Varga, Adam^d | Nemeth, Norbert^d | Soltesz, Pal^{a; *}

Affiliations: [a] Division of Angiology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary | [b] Department of Neurology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary | [c] Department of Food Technology, Faculty of Agricultural and Food Sciences and Environmental Management University of Debrecen, Debrecen, Hungary | [d] Department of Operative Techniques and Surgical Research, Faculty of Medicine, University of Debrecen, Debrecen, Hungary

Correspondence: [*] Corresponding author: Pal Soltesz, MD, PhD, DSc, Division of Angiology, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Moricz Zs. krt. 22, 4032 Debrecen, Hungary. E-mail: dr.soltesz.pal@gmail.com.

Abstract: BACKGROUND: Rheopheresis is a selective extracorporal double cascade filtration treatment, which can extract high molecular weight proteins being responsible for hyperviscosity. As the whole blood and plasma viscosity decrease microcirculation improves. OBJECTIVE: In this preliminary study we aimed to analyze additional beneficial effects of rheopheresis treatment with changes of pro-inflammantory cytokine levels in diabetic foot syndrome patients. METHODS: Two rheopheresis treatments were performed for 6 patients with diabetic foot ulcer and/or neuropathy on consecutive days. Before and after the treatments whole blood and plasma viscosity, as well as IL-6, IL-8, and TNF-alpha serum levels were determined, and complex angiological and ENG examinations were performed. RESULTS: Rheopheresis decreased the whole blood and plasma viscosity, and the serum levels of IL-6, IL-8, and TNF-alpha were markedly reduced. The life quality of the patients improved, the ulcers healed, the pain decreased. Daily dose of analgesics decreased in the follow-up period (6 months). The ENG showed improving amplitude and/or normalizing conduction speed. CONCLUSION: Application of rheopheresis in patients with diabetic foot syndrome has a beneficial effect, providing favorable rheological condition, normalizing cytokine profile and reducing the sensorineural symptoms.

Keywords: Rheopheresis, diabetic foot syndrome, blood viscosity, plasma viscosity, cytokines

DOI: 10.3233/CH-211188

Journal: Clinical Hemorheology and Microcirculation, vol. 80, no. 2, pp. 117-125, 2022