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1.
Mater Sci Eng C Mater Biol Appl ; 121: 111859, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33579491

RESUMO

In this study, we developed a method to prepare inorganic nanoparticles in situ on the surface of cationized cellulose using a rapid microwave-assisted synthesis. Selenium nanoparticles (SeNPs) were employed as a novel type of antimicrobial agent and, using the same method, silver nanoparticles (AgNPs) were also prepared. The results demonstrated that both SeNPs and AgNPs of about 100 nm in size were generated on the cationized cellulose fabrics. The antibacterial tests revealed that the presence of SeNPs clearly improved the antibacterial performance of cationized cellulose in a similar way as AgNPs. The functionalised fabrics demonstrated strong antibacterial activity when assessed using the challenge test method, even after repeated washing. Microscopic investigations revealed that the bacterial cells were visually damaged through contact with the functionalised fabrics. Furthermore, the functionalised fabrics showed low cytotoxicity towards human cells when tested in vitro using an indirect contact method. In conclusion, this study provides a new approach to prepare cationic cellulose fabrics functionalised with Se or Ag nanoparticles, which exhibit excellent antimicrobial performance, low cytotoxicity and good laundry durability. We have demonstrated that SeNPs can be a good alternative to AgNPs and the functionalised fabrics have great potential to serve as an anti-infective material.


Assuntos
Anti-Infecciosos , Nanopartículas Metálicas , Selênio , Antibacterianos/farmacologia , Anti-Infecciosos/farmacologia , Celulose , Humanos , Testes de Sensibilidade Microbiana , Prata
2.
Sci Rep ; 9(1): 5629, 2019 04 04.
Artigo em Inglês | MEDLINE | ID: mdl-30948767

RESUMO

Oral intestinal adsorbents (enterosorbents) are orally administered materials which pass through the gut where they bind (adsorb) various substances. The enterosorbent Enterosgel (Polymethylsiloxane polyhdrate) is recommended as a symptomatic treatment for acute diarrhoea and chronic diarrhoea associated with irritable bowel syndrome (IBS). Since 1980's there have been many Enterosgel clinical trials, however, the detailed mechanism of Enterosgel action towards specific toxins and interaction with concomitantly administered medications has not been fully investigated. Our in vitro study assessed the adsorption capacity of Enterosgel for bacterial enterotoxins and endotoxin, bile acids and interaction with the pharmaceutical drugs; Cetirizine and Amitriptyline hydrochloride. Our data demonstrate the good adsorption capacity of Enterosgel for bacterial toxins associated with gastrointestinal infection, with a lower than the comparator charcoal Charcodote capacity for bile acids whose levels can be raised in IBS patients. Adsorption capacity for the two drugs varied but was significantly lower than Charcodote. These findings suggest that the mechanism of Enterosgel action in the treatment of gastrointestinal infection or IBS is adsorption of target molecules followed by removal from the body. This therapy offers a drug free approach to prevention and treatment of infectious and chronic non-infectious diseases, where intestinal flora and endotoxemia play a role.


Assuntos
Enteroadsorção/métodos , Silicones/química , Silicones/farmacologia , Adsorção , Amitriptilina/metabolismo , Toxinas Bacterianas/metabolismo , Ácidos e Sais Biliares/metabolismo , Cetirizina/metabolismo , Carvão Vegetal , Diarreia/tratamento farmacológico , Gastroenteropatias/tratamento farmacológico , Microbioma Gastrointestinal/efeitos dos fármacos , Síndrome do Intestino Irritável/tratamento farmacológico
3.
Sci Total Environ ; 630: 1237-1245, 2018 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-29554745

RESUMO

Development of porous carbons with high specific surface area (>1200mg-1) targeted at nitrate removal from aqueous solutions is investigated by chemical activation of carbonized rice husk. Potassium carbonate is used as activating and desilicating agent. The effect of post-synthetic treatment by gas phase ammoxidation with ozone/ammonia or oxidation with concentrated nitric acid followed by nitrification with urea on main physicochemical properties and on the effectiveness of the activated carbons in nitrate removal is compared with those determined for a pristine activated carbonized rice husk sample. The two-fold enhancement of nitrate removal by the urea-modified activated carbon in comparison with pristine and ammoxidated sample is in direct correlation with the development of surface basic groups.


Assuntos
Carvão Vegetal/química , Nitratos/química , Eliminação de Resíduos Líquidos/métodos , Poluentes Químicos da Água/química , Nitratos/análise , Oryza/química , Poluentes Químicos da Água/análise
4.
Biomed Mater ; 12(3): 035001, 2017 May 10.
Artigo em Inglês | MEDLINE | ID: mdl-28270638

RESUMO

Nanoporous adsorbents are promising materials to augment the efficacy of haemodialysis for the treatment of end stage renal disease where mortality rates remain unacceptably high despite improvements in membrane technology. Complications are linked in part to inefficient removal of protein bound and high molecular weight uraemic toxins including key marker molecules albumin bound indoxyl sulphate (IS) and p-cresyl sulphate (PCS) and large inflammatory cytokines such as IL-6. The following study describes the assessment of a nanoporous activated carbon monolith produced using a novel binder synthesis route for scale up as an in line device to augment haemodialysis through adsorption of these toxins. Small and large monoliths were synthesised using an optimised ratio of lignin binder to porous resin of 1 in 4. Small monoliths showing combined significant IS, p-CS and IL-6 adsorption were used to measure haemocompatibility in an ex vivo healthy donor blood perfusion model, assessing coagulation, platelet, granulocyte, T cells and complement activation, haemolysis, adsorption of electrolytes and plasma proteins. The small monoliths were tested in a naive rat model and showed stable blood gas values, blood pressure, blood biochemistry and the absence of coagulopathies. These monoliths were scaled up to a clinically relevant size and were able to maintain adsorption of protein bound uraemic toxins IS, PCS and high molecular weight cytokines TNF-α and IL-6 over 240 min using a flow rate of 300 ml min-1 without platelet activation. The nanoporous monoliths where haemocompatible and retained adsorptive efficacy on scale up with negligible pressure drop across the system indicating potential for use as an in-line device to improve haemodialysis efficacy by adsorption of otherwise poorly removed uraemic toxins.


Assuntos
Resinas Acrílicas/química , Remoção de Componentes Sanguíneos/instrumentação , Lignina/química , Nanopartículas/química , Diálise Renal/instrumentação , Ultrafiltração/métodos , Uremia/sangue , Absorção Fisico-Química , Adsorção , Remoção de Componentes Sanguíneos/métodos , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Teste de Materiais , Nanopartículas/ultraestrutura , Nanoporos/ultraestrutura , Diálise Renal/métodos , Ultrafiltração/instrumentação , Uremia/prevenção & controle
5.
Biomaterials ; 50: 140-53, 2015 May.
Artigo em Inglês | MEDLINE | ID: mdl-25736504

RESUMO

Polymeric cryogels are efficient carriers for the immobilization of biomolecules because of their unique macroporous structure, permeability, mechanical stability and different surface chemical functionalities. The aim of the study was to demonstrate the potential use of macroporous monolithic cryogels for biotoxin removal using anthrax toxin protective antigen (PA), the central cell-binding component of the anthrax exotoxins, and covalent immobilization of monoclonal antibodies. The affinity ligand (protein A) was chemically coupled to the reactive hydroxyl and epoxy-derivatized monolithic cryogels and the binding efficiencies of protein A, monoclonal antibodies to the cryogel column were determined. Our results show differences in the binding capacity of protein A as well as monoclonal antibodies to the cryogel adsorbents caused by ligand concentrations, physical properties and morphology of surface matrices. The cytotoxicity potential of the cryogels was determined by an in vitro viability assay using V79 lung fibroblast as a model cell and the results reveal that the cryogels are non-cytotoxic. Finally, the adsorptive capacities of PA from phosphate buffered saline (PBS) were evaluated towards a non-glycosylated, plant-derived human monoclonal antibody (PANG) and a glycosylated human monoclonal antibody (Valortim(®)), both of which were covalently attached via protein A immobilization. Optimal binding capacities of 108 and 117 mg/g of antibody to the adsorbent were observed for PANG attached poly(acrylamide-allyl glycidyl ether) [poly(AAm-AGE)] and Valortim(®) attached poly(AAm-AGE) cryogels, respectively, This indicated that glycosylation status of Valortim(®) antibody could significantly increase (8%) its binding capacity relative to the PANG antibody on poly(AAm-AGE)-protien-A column (p < 0.05). The amounts of PA which remained in the solution after passing PA spiked PBS through PANG or Valortim bound poly(AAm-AGE) cryogel were significantly (p < 0.05) decreased relative to the amount of PA remained in the solution after passing through unmodified as well as protein A modified poly(AAm-AGE) cryogel columns, indicates efficient PA removal from spiked PBS over 60 min of circulation. The high adsorption capacity towards anthrax toxin PA of the cryogel adsorbents indicated potential application of these materials for treatment of Bacillus anthracis infection.


Assuntos
Anticorpos Monoclonais/metabolismo , Antígenos de Bactérias/isolamento & purificação , Toxinas Bacterianas/isolamento & purificação , Criogéis , Proteínas Imobilizadas/metabolismo , Proteína Estafilocócica A/metabolismo , Resinas Acrílicas/química , Adsorção , Animais , Soluções Tampão , Morte Celular , Linhagem Celular , Sobrevivência Celular , Cricetinae , Criogéis/metabolismo , Humanos , Fenômenos Mecânicos , Microscopia Confocal , Porosidade , Soluções , Espectroscopia de Infravermelho com Transformada de Fourier , Temperatura
6.
J Mater Sci Mater Med ; 25(6): 1589-97, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24573455

RESUMO

Adsorbents designed with porosity which allows the removal of protein bound and high molecular weight uraemic toxins may improve the effectiveness of haemodialysis treatment of chronic kidney disease (CKD). A nanoporous activated carbon monolith prototype designed for direct blood contact was first assessed for its capacity to remove albumin bound marker toxins indoxyl sulphate (IS), p-cresyl sulphate (p-CS) and high molecular weight cytokine interleukin-6 in spiked healthy donor studies. Haemodialysis patient blood samples were then used to measure the presence of these markers in pre- and post-dialysis blood and their removal by adsorbent recirculation of post-dialysis blood samples. Nanopores (20-100 nm) were necessary for marker uraemic toxin removal during in vitro studies. Limited removal of IS and p-CS occurred during haemodialysis, whereas almost complete removal occurred following perfusion through the carbon monoliths suggesting a key role for such adsorbent therapies in CKD patient care.


Assuntos
Carvão Vegetal/química , Cresóis/isolamento & purificação , Hemofiltração/instrumentação , Indicã/isolamento & purificação , Interleucina-6/isolamento & purificação , Diálise Renal/instrumentação , Ésteres do Ácido Sulfúrico/isolamento & purificação , Uremia/sangue , Absorção , Cresóis/sangue , Desenho de Equipamento , Análise de Falha de Equipamento , Humanos , Indicã/sangue , Interleucina-6/sangue , Teste de Materiais , Membranas Artificiais , Projetos Piloto , Ésteres do Ácido Sulfúrico/sangue , Uremia/prevenção & controle
7.
Int J Artif Organs ; 36(9): 624-32, 2013 Oct 03.
Artigo em Inglês | MEDLINE | ID: mdl-23918264

RESUMO

The aim of the present study was to develop and investigate nanoporous activated carbon materials for their ability to adsorb inflammatory cytokines directly from blood, for a range of therapeutic applications, including: systemic inflammatory response syndrome (SIRS) related to sepsis, cardio-pulmonary by-pass surgery, or ischemic reperfusion injury. Building on the previously established relationship between the porous structure of beaded polymer-derived activated carbon and its capacity to adsorb inflammatory molecules, we have developed and characterized monolithic porous carbon columns produced from the same polymer precursor matrix as carbon microbeads. The monolithic columns developed were assessed for their ability to adsorb inflammatory molecules from blood in a circulating system. Preliminary findings demonstrated good removal of the inflammatory cytokines IL-8 (100% removal), IL-6 (80% removal), and TNF (51% removal) from blood. The efficiency of cleansing is dependent on the size of the adsorbed molecule and the porous structure of the monolith, highlighting their potential for use as a hemoadsorption device.


Assuntos
Citocinas/sangue , Sepse/terapia , Adsorção , Carbono/química , Circulação Extracorpórea , Humanos , Interleucina-6/sangue , Interleucina-8/sangue , Microesferas , Porosidade , Sepse/sangue , Fator de Necrose Tumoral alfa/sangue
9.
ACS Appl Mater Interfaces ; 4(11): 5936-44, 2012 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-23088424

RESUMO

A set of glutaraldehyde (GA) cross-linked poly(vinyl alcohol)/activated carbon (PVA/GA/AC) composites prepared in the form of monolithic rods using a cryogelation technique and studied using adsorption, mercury porosimetry, scanning electron microscopy (SEM), and quantum chemistry methods display porosity similar to that of PVA/GA cryogel at a high GA content (content ratio GA/AC = 1 and GA/PVA = 0.2). GA cross-linked PVA multilayer coverage is an effective barrier for adsorption on AC particles. Variations in surface chemistry (AC initial and oxidized in air at 300 °C for 12 h) and content (14-62.5%w/w) of ACs in PVA/GA/AC composites relatively weakly affect their textural characteristics at a high GA content (specific surface area S(BET) < 120 m²/g, pore volume V(p) < 0.35 cm³/g). However, PVA/GA/AC composite rods formed with a lower concentration of GA (content ratio GA/AC = 1/6 and GA/PVA = 1/10) have significantly greater S(BET) (∼500 m²/g) and V(p) (>0.55 cm³/g) values because of improved accessibility of the AC surface. This provides better adsorption of methylene blue as a probe compound.


Assuntos
Carvão Vegetal/química , Azul de Metileno/isolamento & purificação , Álcool de Polivinil/química , Ultrafiltração/métodos , Absorção , Teste de Materiais , Azul de Metileno/química , Microesferas , Tamanho da Partícula , Propriedades de Superfície
10.
Biomacromolecules ; 12(10): 3733-40, 2011 Oct 10.
Artigo em Inglês | MEDLINE | ID: mdl-21842874

RESUMO

In the course of severe pathological conditions, such as acute liver failure and sepsis, toxic metabolites and mediators of inflammation are released into the patient's circulation. One option for the supportive treatment of these conditions is plasmapheresis, in which plasma, after being separated from the cellular components of the blood, is cleansed by adsorption of harmful molecules on polymers or activated carbon. In this work, the adsorption characteristics of activated carbon beads with levels of activation ranging from 0 to 86% were assessed for both hydrophobic compounds accumulating in liver failure (bilirubin, cholic acid, phenol and tryptophan) and cytokines (tumor necrosis factor α and interleukin-6). Progressive activation resulted in significant gradual reduction of both bulk density and mean particle size, in an increase in the specific surface area, and to changes in pore size distribution with progressive broadening of micropores. These structural changes went hand in hand with enhanced adsorption of small adsorbates, such as IL-6 and cholic acid and, to a lesser extent, also of large molecules, such as TNF-α.


Assuntos
Inflamação/terapia , Falência Hepática Aguda/terapia , Plasmaferese/métodos , Adsorção , Bilirrubina/sangue , Carbono/química , Colatos/sangue , Humanos , Inflamação/sangue , Inflamação/complicações , Inflamação/fisiopatologia , Interleucina-6/sangue , Falência Hepática Aguda/sangue , Falência Hepática Aguda/complicações , Falência Hepática Aguda/fisiopatologia , Tamanho da Partícula , Fenol/sangue , Porosidade , Triptofano/sangue , Fator de Necrose Tumoral alfa/sangue
11.
J Colloid Interface Sci ; 358(2): 582-92, 2011 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-21457992

RESUMO

The textural and adsorption characteristics of a series of activated carbons (ACs), porous poly(vinyl alcohol) (PVA) gels, and PVA/AC composites were studied using scanning electron microscopy, mercury porosimetry, adsorption of nitrogen (at 77.4 K), cationic methylene blue (MB), anionic methyl orange (MO), and Congo red (CR) from the aqueous solutions. Dye-PVA-AC-water interactions were modeled using the semiempirical quantum chemical method PM6. The percentage of dye removed (C(rem)) by the ACs was close to 100% at an equilibrium concentration (C(eq)) of less than 0.1 mM but decreased with increasing dye concentration. This decrease was stronger at C(eq) of less than 1 mM, and C(rem) was less than 50% at a C(eq) of 10-20 mM. For PVA and the PVA/AC composite containing C-7, the C(rem) values were minimal (<75%). The free energy distribution functions (f(ΔG)) for dye adsorption include one to three peaks in the -ΔG range of 1-60 kJ/mol, depending on the dye concentration range used and the spatial, charge symmetry of the hydrated dye ions and the structural characteristics of the adsorbents. The f(ΔG) shape is most complex for MO with the most asymmetrical geometry and charge distribution and adsorbed at concentrations over a large C(eq) range. For symmetrical CR ions, adsorbed over a narrow C(eq) range, the f(ΔG) plot includes mainly one narrow peak. MB has a minimal molecular size at a planar geometry (especially important for effective adsorption in slit-shaped pores) which explains its greater adsorptive capacity over that of MO or CR. Dye adsorption was greatest for ACs with the largest surface area but as molecular size increases adsorption depends to a greater extent on the pore size distribution in addition to total and nanopore surface areas and pore volume.


Assuntos
Carvão Vegetal/química , Corantes/isolamento & purificação , Recuperação e Remediação Ambiental/métodos , Polivinil/química , Adsorção , Resinas Compostas , Hidrogéis , Íons
12.
Biomaterials ; 30(18): 3143-9, 2009 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-19299007

RESUMO

The purpose of this study was to consider the use of a hydroxyapatite (HA) coated porous carbon matrix as a synthetic dental laminate substitute in osteo-odonto-keratoprosthetic (OOKP) design. 3 types of carbon meshes were coated with HA by sonoelectrochemical deposition. The materials were characterised by scanning electron microscopy (SEM) and HA deposition was characterised by elemental analysis and X-ray diffractometry (XRD). In vitro assays were carried out to quantify the effects of HA coating on human keratocyte adhesion. Cellular cytokine production was used to assess inflammatory potential. HA coating significantly increased keratocyte adhesion to the carbon matrix (p<0.01). The materials did not induce excessive cytokine production by the adherent keratocytes. In addition, the matrices themselves adsorbed significant levels of the cytokine IL-8 (p<0.05). The results indicate that HA coated carbon matrices provide a suitable environment to enhance in-growth of corneal cells without inducing further inflammation. The materials may also suppress excessive inflammation by adsorption of the cytokine IL-8 into the porous, internal carbon structure.


Assuntos
Carbono , Materiais Revestidos Biocompatíveis , Opacidade da Córnea/cirurgia , Durapatita , Implantes Experimentais , Telas Cirúrgicas , Adsorção , Carbono/toxicidade , Células Cultivadas/efeitos dos fármacos , Células Cultivadas/metabolismo , Materiais Revestidos Biocompatíveis/toxicidade , Córnea/citologia , Microanálise por Sonda Eletrônica , Humanos , Implantes Experimentais/efeitos adversos , Interleucina-6/química , Interleucina-6/metabolismo , Interleucina-8/química , Interleucina-8/metabolismo , Ceratite/prevenção & controle , Teste de Materiais , Microscopia Eletrônica de Varredura , Difração de Raios X
13.
Biomaterials ; 29(11): 1638-44, 2008 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-18207234

RESUMO

A prototype in-line filtration/adsorption device has been developed using novel synthetic pyrolysed carbon monoliths with controlled mesoporous domains of 2-50nm. Porosity was characterized by SEM and porosimetry. Removal of inflammatory cytokines TNF, IL-6, IL-1beta and IL-8 was assessed by filtering cytokine spiked human plasma through the walls of the carbon modules under pressure. The effect of carbon filtration on plasma clotting response and total plasma protein concentration was also assessed. Significant removal of the cytokines IL-6, IL-1beta and IL-8 was observed. Initially marked TNF removal diminished over time. The coagulation studies indicated that the carbon device does not exacerbate the propensity of blood plasma to clot. The total plasma protein concentration remained constant. The device offers a broader approach to the treatment of systemic inflammatory response syndrome (SIRS) by the removal of inflammatory mediators central to its progression.


Assuntos
Tecnologia Biomédica/instrumentação , Tecnologia Biomédica/métodos , Carbono/química , Citocinas/isolamento & purificação , Adsorção , Proteínas Sanguíneas/metabolismo , Citocinas/sangue , Humanos , Inflamação/sangue , Microscopia Eletrônica de Varredura
14.
Biomaterials ; 27(34): 5755-62, 2006 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-16914195

RESUMO

Porous carbons can be used for the purification of various bio-fluids, including the cleansing blood of inflammatory mediators in conditions such as sepsis or auto-immune diseases. Here we show that the control of pore size in carbons is a key factor to achieving efficient removal of cytokines. In particular, the surface area accessible by the protein governs the rate and effectiveness of the adsorption process. We demonstrate that novel mesoporous carbon materials synthesized from ternary MAX-phase carbides can be optimized for efficient adsorption of large inflammatory proteins. The synthesized carbons, having tunable pore size with a large volume of slit-shaped mesopores, outperformed all other materials or methods in terms of efficiency of TNF-alpha removal and the results are comparable only with highly specific antibody-antigen interactions.


Assuntos
Carbono/química , Citocinas/isolamento & purificação , Adsorção , Citocinas/sangue , Humanos , Microscopia Eletrônica de Transmissão , Porosidade , Propriedades de Superfície , Fator de Necrose Tumoral alfa/isolamento & purificação
15.
Biomaterials ; 27(30): 5286-91, 2006 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-16806458

RESUMO

This study investigated a range of phenol-formaldehyde-aniline-based pyrolysed carbon matrices and their component materials, for their ability to adsorb a range of inflammatory cytokines crucial to the progression of sepsis. The efficiency of adsorption of the target molecules from human plasma was assessed and compared to that of Adsorba 300C, a commercially available cellulose-coated activated charcoal. Results indicate that a number of the primary carbon/resin materials demonstrate efficient adsorption of the cytokines studied here (TNF, IL-6 and IL-8), comparable to other adsorbents under clinical investigation. Our findings also illustrate that these adsorbent capabilities are retained when the primary particles are combined to form a pyrolysed carbon matrix. This capability will enable the engineering of the carbon matrix porosity allowing a blend of carbonised particle combinations to be tailored for maximum adsorption of inflammatory cytokines. The present findings support further investigation of this carbon material as a combined carbon-based filtration/adsorbent device for direct blood purification.


Assuntos
Carbono/química , Citocinas/sangue , Resinas Sintéticas/química , Adsorção , Carvão Vegetal/química , Citocinas/química , Humanos , Sepse/terapia
16.
Biomaterials ; 26(34): 7124-31, 2005 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-15967498

RESUMO

The aim of the present study was to conduct a preliminary investigation into the blood biocompatibility of a novel, uncoated carbon for use in a filtration/adsorption device for the treatment of sepsis. Carbon well prototypes were manufactured from phenol-formaldehyde-aniline-based pyrolysed carbons using monolithic polymer technology. Inflammatory blood cell and plasma protein mediation of the inflammatory response were evaluated using the novel carbon prototypes and compared with dialyser membrane and tissue culture plate controls. Assays determining monocyte and granulocyte adhesion, platelet adhesion and activation, granulocyte activation and complement activation were performed. Preliminary findings suggest an adsorptive but passivating carbon surface. Moderate levels of monocyte and granulocytes adhesion were seen in conjunction with adsorption of plasma proteins to the carbon surface. Activation of granulocyte and adherent platelets was not detected and the complement cascade was not activated by the carbons, indicating a surface compatible with blood contact. The results support the further development of the proposed carbon-based device for the treatment of sepsis.


Assuntos
Materiais Biocompatíveis/farmacologia , Carbono/farmacologia , Carbono/uso terapêutico , Ativação do Complemento/efeitos dos fármacos , Monócitos/efeitos dos fármacos , Monócitos/imunologia , Ativação Plaquetária/efeitos dos fármacos , Adesividade Plaquetária/efeitos dos fármacos , Materiais Biocompatíveis/uso terapêutico , Células Cultivadas , Humanos , Teste de Materiais , Diálise Renal/métodos , Sepse/imunologia , Sepse/terapia
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