title: Expression of VLA-4 on peripheral mononuclear cells in patients on chronic haemodialysis with carpal tunnel syndrome.
abstract: BACKGROUND
  Carpal tunnel syndrome (CTS) is a major complication in long-term haemodialysis patients and is thought to be a form of haemodialysis-associated amyloidosis. CTS may be due to the deposition of amyloid as well as local inflammatory process in the carpal tunnel. Although macrophage-like cells infiltrating the tenosynovium of carpal tunnel are known to express mRNA for adhesion molecules, the level of expression of adhesion molecules on peripheral blood mononuclear cells (PBMC) in patients with CTS is unknown.
  
  
  METHODS
  We compared the expression of very late activation antigen (VLA-4) on PBMC by flow cytometry in 14 patients on haemodialysis (6-21 years) with CTS, nine on haemodialysis (1-6 years) but without CTS and six patients on chronic ambulatory peritoneal dialysis (CAPD, 1-5 years) without CTS.
  
  
  RESULTS
  The expression of VLA-4 on peripheral lymphocytes was not different among the groups. However, the FACScan fluorescence histogram of VLA-4 expression on peripheral monocytes showed a bimodal pattern in the CTS group, and the rate of the high intensity portion of the expressed VLA-4 on monocytes was significantly higher in CTS than other groups (P<0.05). The observed differences were not based on differences in the type of the dialysis membrane. We also examined the adhesion of PBMC to fibronectin-coated plates. The number of adherent PBMC was significantly higher in patients with CTS than in other groups (P<0.05).
  
  
  CONCLUSIONS
  Our results suggest that increased expression of VLA-4 on peripheral monocytes and augmented adhesion capacity of PBMC to fibronectin may be involved in the development of CTS in haemodialysis patients.
authors.affiliation: The Second Department of Internal Medicine, Nagasaki University School of Medicine, Sakamoto, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Ogino
authors.forename: S
authors.initials: S
authors.lastname: Namie
authors.forename: Y
authors.initials: Y
authors.lastname: Ozono
authors.forename: M
authors.initials: M
authors.lastname: Miyazaki
authors.forename: T
authors.initials: T
authors.lastname: Harada
authors.forename: S
authors.initials: S
authors.lastname: Kohno
mesh_terms: D002349:Carpal Tunnel Syndrome / Q000097:blood* / Q000209:etiology*; D002448:Cell Adhesion / Q000502:physiology; D005353:Fibronectins / Q000502:physiology; D005455:Fluorescent Antibody Technique; D006801:Humans; D039041:Integrin alpha4beta1; D016023:Integrins / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism* / Q000502:physiology; D010531:Peritoneal Dialysis, Continuous Ambulatory; D016201:Receptors, Lymphocyte Homing / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*; D013997:Time Factors
chemical_list: D005353:Fibronectins; D039041:Integrin alpha4beta1; D016023:Integrins; D016201:Receptors, Lymphocyte Homing