London researchers have repurposed a machine normally used to clean kidney patients' blood in an effort to treat the most critical COVID-19 patients.
In a world-first, Lawson Health Research Institute scientists are using a modified dialysis device to remove a patient's blood and reprogram white blood cells before returning the blood to the body. The treated cells help to fight hyper inflammation triggered by the virus.
“Working in the intensive care unit (ICU), I was aware that more treatment options were needed in the fight against COVID-19,” Dr. Chris McIntyre, lead researcher, Lawson scientist and LHSC Nephrologist, said in a statement. “This led to the idea of treating a patient’s blood outside of the body. We could reprogram white blood cells associated with inflammation to alter the immune response.”
In the most severely ill COVID-19 patients, the virus causes a heightened immune response, known as a ‘cytokine storm,' which can lead to severe inflammation.
Using the modified dialyzer, called an extracorporeal leukocyte modifying device, researchers are able to remove the blood in a much slower manner than standard dialysis. They can then use specific levels of biochemical components to target and transform white blood cells associated with inflammation before releasing them back into circulation in the body.
The technique was used on its first patient at the London Health Sciences Centre last week. It is said to have drastically improved the unidentified individual's chance of survival. A clinical trial is being launched at Victoria and University hospitals in London. Up to 40 critically ill patients with COVID-19 will take part. Some will receive the standard supportive care used around the world, while others will be treated using the modified form of dialysis. Researchers will compare results from the two different treatment approaches to determine if reprogramming the white blood cells is effective.
“The ultimate goal is to improve patient survival and lessen their dependency on oxygen and ventilation,” said McIntyre. “If effective, it’s possible that this treatment could be combined with other therapies. For example, this could be used to modulate inflammatory consequences while an antiviral drug is used to reduce the viral load.”
The trial is using insights gained from another local study at the London Health Sciences Centre which analyzes blood samples from COVID-19 patients to better understand the cytokine storm.
If the new treatment is deemed successful it could also be used to treat other conditions, including sepsis.