Cytokines are small proteins that normally regulate and control the immune response. Common classes of cytokines are interleukins, interferons, lymphokines, tumor necrosis factor, and others. There are more than 100 different pro-inflammatory and anti-inflammatory cytokines, many with overlapping function, that are released by a wide variety of immune and somatic cells. Normally anti-inflammatory and pro-inflammatory cytokines are in balance, maintaining immune homeostasis. However, in severe injury and infection, there is often an excess of one, or both. This can trigger an upward spiral of additional cytokine production, leading to a “cytokine storm”.
Cytokine storm is toxic and can lead directly to cell death and organ injury, while triggering a hyperinflammatory response that can potentiate severity of illness and death in critical illnesses. For example, in sepsis – defined as organ dysfunction caused by a dysregulated host response to an infection, cytokine storm often plays a dangerous role. Currently, there are no approved specific treatments of sepsis. Many attempts to control cytokine storm in sepsis with targeted anti-inflammatory or immunosuppressant drugs or biologics have failed.
CytoSorb is an extracorporeal cytokine adsorber that is capable of removing a broad range of cytokines, often called a cytokine storm, with more than 45,000 square meters of surface area, or 7 football fields of surface area, to bind cytokines in a single CytoSorb cartridge.