Blood-membrane interaction in hemodialysis leads to increased cytokine production.
Recently much interest has been focused on the role of immunoregulatory cytokines such as interleukin 1 (IL 1) and interleukin 2 (IL 2) during the pathogenesis of immunological as well as inflammatory diseases. Therefore peripheral blood mononuclear cells (PBMC) of eight patients undergoing hemodialysis (HD) were tested for IL 1 and IL 2 production. Before starting HD, cytokine production by PBMC in culture was not altered in comparison to normal healthy controls, however, a significant increase of IL 1 and IL 2 production was observed within the first HD hour which lasted throughout the end of HD. Moreover direct effects of cellulose membranes on PBMC cytokine production as well as serum IL 1 levels have been investigated. Serum IL 1 levels were already elevated before onset of HD and increased further during HD. The discrepancy between PBMC IL 1 production and serum IL 1 levels may be due to the diminished excretion in patients with end-stage renal disease. Since addition of dialysis membrane particles enhanced monocytes to produce more IL 1 as well as lymphocytes to release more IL 2, a direct stimulatory membrane effect is postulated. The increased release of immunoregulatory cytokines may account for some of the pathologic findings observed during hemodialysis.
D000328:Adult; D002482:Cellulose; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D007375:Interleukin-1 / Q000096:biosynthesis* / Q000097:blood; D007376:Interleukin-2 / Q000096:biosynthesis* / Q000097:blood; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D006435:Renal Dialysis; D013601:T-Lymphocytes / Q000378:metabolism
D007375:Interleukin-1; D007376:Interleukin-2; D008567:Membranes, Artificial; D002482:Cellulose