title: Is contact activation of the coagulation system involved in the genesis of the first-use syndrome?
abstract: A number of mechanisms have been thought to be involved in the pathogenesis of the first-use syndrome. These include IgE antibody-mediated response to ethylene oxide-related antigens, membrane activation of the alternative complement pathway, activation of tissue mast cells and basophils by materials released from the dialyzer into the circulation, and transfer of bacterial products through high flux dialyzer. However, the possible role of the activation of blood coagulation system and platelets during dialysis has not been considered. The present communication reviews the theoretical basis for a possible connection between dialysis-induced activation of platelets and coagulation system with the first-use syndrome. Although the available data concerning the activation of intrinsic coagulation pathway during dialysis are conflicting, there is no controversy as to the occurrence of platelet activation. It is suggested that biochemical events triggered by activation of these systems may in part contribute to the genesis of first-use syndrome.
mesh_terms: D000707:Anaphylaxis / Q000209:etiology; D000906:Antibodies / Q000276:immunology; D001491:Basophils / Q000187:drug effects; D001777:Blood Coagulation; D001792:Blood Platelets / Q000276:immunology*; D002482:Cellulose / Q000009:adverse effects / Q000031:analogs & derivatives / Q000276:immunology; D003167:Complement Activation / Q000187:drug effects; D003176:Complement C3 / Q000096:biosynthesis; D015926:Complement C3a; D003182:Complement C5 / Q000096:biosynthesis; D015936:Complement C5a; D003170:Complement Pathway, Alternative / Q000187:drug effects; D005027:Ethylene Oxide / Q000009:adverse effects / Q000276:immunology; D005174:Factor XII; D006967:Hypersensitivity / Q000209:etiology*; D007073:Immunoglobulin E / Q000276:immunology; D007688:Kidneys, Artificial / Q000009:adverse effects; D008407:Mast Cells / Q000187:drug effects; D006435:Renal Dialysis / Q000009:adverse effects*; D013577:Syndrome
chemical_list: D000906:Antibodies; D003176:Complement C3; D003182:Complement C5; D007073:Immunoglobulin E; D015926:Complement C3a; D015936:Complement C5a; D005174:Factor XII; D002482:Cellulose; C009865:cuprammonium cellulose; D005027:Ethylene Oxide