Body of text: I/R injury of the small intestine is consequently a critical problem that is important. DHP-PMX therapy can remove circulating endotoxins and reduce various cytokines, even in patients with high levels of plasma cytokines. DHP-PMX therapy has also been attempted for severe sepsis secondary to intra-abdominal infection, acute lung injury, and acute respiratory distress syndrome caused by sepsis, and its effectiveness has been reported.

A research article to be published on September 21, 2008 in the World Journal of Gastroenterology addresses this question. The research team led by Prof. Izumi Takeyoshi from Gunma University Graduate School of Medicine in Japan hypothesized that DHP-PMX therapy could reduce I/R injury and demonstrated the usefulness of this therapy on pulmonary warm I/R injury in a canine model.

The Authors suggested that the absorption of anandamide by PMX might abolish the diverse negative effects of anandamide such as hypotension, immunosuppression, and cytotoxicity. Taking these results into consideration, the possibility exists that treatment with PMX not only removes endotoxin, but also reduces inflammatory reactions through the inhibition of various inflammatory cascades and has an effective role on I/R injury.

They demonstrated that direct hemoperfusion with a polymyxin B-immobilized cartridge reduced the reperfusion injury in small intestine. DHP-PMX therapy reduced warm I/R injury of the small intestine, and IL-10 may play a role to inhibit I/R injury with DHP-PMX therapy. This study was nicely designed and performed.