C5b-9 generation and cytokine production in hemodialyzed patients.
The role of the complement system in the induction of cytokine release is controversial. Plasma terminal C complex C5b-9 along with Bb and C4d fragments were evaluated in 22 patients during routine acetate or bicarbonate hemodialysis using cuprophane membranes and hemodiafiltration (HDF) or acetate-free-biofiltration (AFB) using polyacrylonitrile (PAN) membranes. In a subgroup of six uremic patients we also evaluated the release of tumor necrosis factor (TNF alpha) and interleukin-6 (IL-6) from monocytes before and after six subsequent sessions with bicarbonate-cuprophane, HDF and AFB-PAN. At beginning of the dialysis increased plasma C5b-9 levels were found in patients treated by acetate or bicarbonate-cuprophane. Moreover, a rapid significant (P < 0.001) increase of C5b-9 levels occurred in both groups 15 minutes after the onset of the hemodialysis procedure with a plateau at 180 minutes. In contrast, only a slight increase in the plasma C5b-9 levels was observed in patients dialysed with HDF or AFB using PAN membranes. This increase was more pronounced with HDF at 0 minutes compared with controls. A positive linear correlation was found in all patients between C5b-9 generation and plasma Bb levels at different times in the dialysis session. The production of C4d fragment remained unchanged in all groups, indicating that C5b-9 complex generation is due to the prevalent alternative complement pathway activation. The pattern of cytokine production strictly resembled the complement system activation and C5b-9 generation.(ABSTRACT TRUNCATED AT 250 WORDS)
Pertosa
G
G
Department of Nephrology, University of Bari, Italy.
Tarantino
E A
EA
Gesualdo
L
L
Montinaro
V
V
Schena
F P
FP
D000368:Aged; D001672:Biocompatible Materials; D015938:Complement Membrane Attack Complex / Q000096:biosynthesis*; D016207:Cytokines / Q000096:biosynthesis*; D005260:Female; D006440:Hemofiltration; D006801:Humans; D008297:Male; D008567:Membranes, Artificial; D009000:Monocytes / Q000502:physiology; D006435:Renal Dialysis
D001672:Biocompatible Materials; D015938:Complement Membrane Attack Complex; D016207:Cytokines; D008567:Membranes, Artificial