Endotoxins modulate chronically tumour necrosis factor alpha and interleukin 6 release by uraemic monocytes.
We examined in vivo the release of tumour necrosis factor alpha (TNF alpha) and interleukin 6 (IL-6) by uraemic monocytes upon stimulation with endotoxin-contaminated bicarbonate concentrate. Twelve uraemic patients underwent 1-month-subsequent periods of standard haemodialysis (SHD) with cuprophane (CU), a high-complement-activating membrane (6 patients), or haemodiafiltration (HDF) with polyacrylonitrile (PAN), a low-complement-activating membrane (6 patients), by using a dialysate prepared with either non-sterile bicarbonate concentrate tanks (phase 1) or sterile bicarbonate concentrate bags (phase 2). TNF alpha and IL-6 concentrations were determined in monocyte supernatants by ELISA; endotoxin levels in bicarbonate concentrates were measured by a chromogenic limulus amoebocyte lysate (LAL) assay. A significant increase in LAL reactivity was found in bicarbonate concentrate tanks compared to sterile bags (P < 0.001). Non-sterile dialysate caused a significant (P < 0.001) predialytic increase in monocyte TNF alpha release as compared to controls and non-dialysed uraemic patients. One month treatment with sterile bicarbonate significantly decreased TNF alpha predialytic activity in monocyte supernatants (P < 0.001) to levels closer to those of non-dialysed uraemic patients. A similar decrease was observed for IL-6 production. Dialytic treatment induced a further increase in both TNF alpha and IL-6 production, particularly in phase 1.(ABSTRACT TRUNCATED AT 250 WORDS)
Pertosa
G
G
Chair of Nephrology, University of Bari, Italy.
Gesualdo
L
L
Bottalico
D
D
Schena
F P
FP
D000328:Adult; D001639:Bicarbonates; D002478:Cells, Cultured; D004731:Endotoxins / Q000009:adverse effects*; D004797:Enzyme-Linked Immunosorbent Assay; D004926:Escherichia coli; D005260:Female; D015312:Hemodialysis Solutions / Q000009:adverse effects; D006801:Humans; D015850:Interleukin-6 / Q000096:biosynthesis*; D008297:Male; D008567:Membranes, Artificial; D008875:Middle Aged; D009000:Monocytes / Q000166:cytology / Q000187:drug effects / Q000378:metabolism*; D006435:Renal Dialysis; D013242:Sterilization; D014409:Tumor Necrosis Factor-alpha / Q000096:biosynthesis*; D014511:Uremia / Q000150:complications* / Q000628:therapy
D001639:Bicarbonates; D004731:Endotoxins; D015312:Hemodialysis Solutions; D015850:Interleukin-6; D008567:Membranes, Artificial; D014409:Tumor Necrosis Factor-alpha