A novel drug, NuSepin, has shown promise in suppressing systemic inflammatory response syndrome (SIRS) resulting from cardiopulmonary bypass (CPB) surgery. A research team led by Professor Seung Zhoo Yoon from Korea University Anam Hospital, in collaboration with Professor Jeong Jun Park from CHA University School of Medicine, demonstrated the efficacy of NuSepin in inhibiting CPB-induced SIRS in animal models, potentially offering a new approach to managing this critical condition. The study, published in Scientific Reports, highlights the drug's ability to maintain stable blood pressure by reducing vascular relaxation.
Inflammatory Response in CPB Surgery
CPB surgery, while essential for many heart operations, can trigger an excessive immune response, leading to SIRS. This syndrome can cause severe fever and attack normal cells, potentially resulting in multi-organ failure and death. Cytokines, regulatory proteins involved in cell proliferation, differentiation, inflammation, and hematopoiesis, play a central role in this process. Despite the critical need, effective and safe medications to address CPB-induced SIRS have been lacking.
NuSepin's Impact on Cytokine Release
In animal experiments, the research team induced proinflammatory cytokine release due to CPB and maintained the procedure for two hours, evaluating the levels of cytokines (TNF-α, IL-1β, IL-6, IL-8) over time. The group treated with NuSepin showed minimal increases in TNF-α, IL-1β, and IL-8 across all intervals, with a sharp decrease in IL-6 levels following the cessation of CPB, indicating a reduction in the inflammatory response. The study reported that plasma concentration of TNF-α at T1 and 2 was 30% lower in Nusepin group (p = 0.057).
Reduction in Vasopressor Use
Furthermore, the required dose of norepinephrine to maintain an average blood pressure of 60mmHg in the test group was reduced to one-hundredth of that of the control group, suggesting that NuSepin can help stabilize blood pressure during surgery and reduce the need for vasopressors.
Clinical Implications
"By overcoming the limitations of current post-heart surgery inflammation management and significantly reducing the release of major inflammatory cytokines such as IL-1β, TNF-α, and IL-6, we can greatly mitigate inflammatory responses and reduce postoperative complications," the research team stated in their paper. They added that this innovation will reduce tissue damage and functional impairment after CPB and help stabilize blood pressure during surgery, thus reducing the need for vasopressors.
Professor Yoon commented, "Compared to other systemic inflammatory diseases, the pathogenesis is relatively simple, so a clinical phase 2 trial with a small number of patients and short-term administration can observe meaningful efficacy. This treatment's effect on post-CPB respiratory failure can significantly improve the quality of life for patients after open-heart surgery."
Future Development
NuSepin, originally developed by Shaperon as a COVID-19 treatment, has already secured safety data from phase 1 and global phase 2 clinical trials, positioning it for rapid advancement to the next stage of clinical development.
