title: Differential activation of monocytes in haemodialysis patients exposed to different types of membranes.
abstract: Peripheral blood mononuclear cells (PBMC) from haemodialysis patients treated with different types of membranes were isolated, incubated in vitro, and extracellular and cell-associated interleukin I (IL-1) assayed by radioimmunological methods. Extracellular IL-1 was low and not different from controls, regardless of the dialyser used. In contrast, cell-associated IL-1 was increased in patients treated with dialysers containing low-flux Cuprophan (CU, n = 5) and polyacrylonitrile sheet membrane (AN69, n = 5). Patients treated with dialysers containing high-flux polysulphone (PS, n = 7), and polymethylmethacrylate (PMMA, n = 8), exhibited no increase in cell-associated IL-1 under these conditions. To elucidate the mechanism of the activation, aqueous extracts of dialysers containing CU, PS, and AN69 were tested for their ability to induce IL-1 generation in PBMC from healthy donors. Extracts from unrinsed CU-containing dialysers caused significant IL-1 synthesis and release, whereas incubation with extracts from dialysers containing PS and AN69 sheet membranes did not. Hence, although both CU and AN69 sheet-type dialysers result in activation of blood monocytes the mechanism of action appears to be different. We speculate that functional signs of PBMC activation as evidenced by increased spontaneous IL-1 production observed in some patients on long-term haemodialysis may result from extractable dialyser membrane material while in other instances direct cell membrane interactions or endotoxin transfer from the dialysate may be relevant.
authors.affiliation: Division of Nephrology, Medical Clinic I Grosshadern, München, FRG.
authors.forename: M
authors.initials: M
authors.lastname: Blumenstein
authors.forename: H W
authors.initials: HW
authors.lastname: Ziegler-Heitbrock
authors.forename: B
authors.initials: B
authors.lastname: Schiller
authors.forename: B
authors.initials: B
authors.lastname: Schmidt
authors.forename: R A
authors.initials: RA
authors.lastname: Ward
authors.forename: H J
authors.initials: HJ
authors.lastname: Gurland
mesh_terms: D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D005260:Female; D006801:Humans; D007375:Interleukin-1 / Q000096:biosynthesis*; D007676:Kidney Failure, Chronic / Q000276:immunology* / Q000628:therapy; D007958:Leukocyte Count; D007963:Leukocytes, Mononuclear / Q000276:immunology / Q000378:metabolism*; D008070:Lipopolysaccharides / Q000378:metabolism; D008213:Lymphocyte Activation / Q000276:immunology*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D006435:Renal Dialysis / Q000009:adverse effects*
chemical_list: D007375:Interleukin-1; D008070:Lipopolysaccharides; D008567:Membranes, Artificial