Bilirubin adsorption properties of water-soluble adsorbents with different cyclodextrin cavities in plasma dialysis system

In this study, we explored the use of α-, β- or γ-cyclodextrin (CD)-grafted polyethyleneimine (PEI) as water-soluble adsorbent for removing excess plasma bilirubin. To evaluate the bilirubin-binding capacity of these adsorbents, bovine serum albumin (BSA) solution or plasma with high level of bilirubin were dialyzed against CD-PEI-spiked dialysate. In BSA solution with an initial biliurbin concentration of 171.5 mg/L, α-CD-PEI, β-CD-PEI and γ-CD-PEI achieved adsorption capacities of 2.5, 5.8 and 3.8 mg/g, respectively. In a plasma dialysis system, 45.6% of bilirubin (260 mg/L) was removed from 200 mL plasma by 1 L dialysate spiked with 10 mg/mL β-CD-PEI, which was significantly higher than that removed by the same volume of BSA-spiked dialysate (P < 0.05), demonstrating the strong bilirubin-binding ability of β-CD-PEI. The key feature of bilirubin adsorption was related to the CD functional group, not the PEI matrix. Subsequent molecular docking study indicated that the size of CD cavity could affect the affinity energy of CD–bilirubin complex. The cavity of β-CD was most suitable for accommodating the pyrrole rings of bilirubin. The inclusion complex of bilirubin and β-CD in the molar ratio of 1:2 was more logical in terms of affinity energy. All the results demonstrated the potential of β-CD-PEI (water-soluble adsorbent) as an effective agent for removing of bilirubin from plasma in dialysis system.