Surface antigen expression and platelet neutrophil interactions in haemodialysis.
BACKGROUND
There is increasing evidence to show the clinical implications of membrane biocompatibility in haemodialysis therapy.


METHODS
We conducted a cross-over clinical study examining the clinical biocompatibility profile of three derivatised cellulosic membranes obtained by means of different modifications to the cellulose polymer (haemophan, cellulose diacetate, benzyl cellulose) in comparison to the parent polymer (cuprophan) and a reference synthetic membrane (polysulfone).


RESULTS
In terms of leukopenia production, derivatised cellulosic membranes were generally intermediate between cuprophan and polysulfone, haemophan being more marked than the other two membranes. Upregulation of CD11b/CD18 molecule on neutrophils was found with all membranes, to a greater extent with the dialyser containing cuprophan. The expression of CD11b/CD18 on monocytes was slightly affected with cuprophan only. The neutrophil and monocyte counts throughout the entire dialysis session showed a much better correlation with the cellular expression of sialyl-Lewis x (CD15s) molecule than with CD11b/CD18 expression. An increased formation of platelet-neutrophil coaggregates occurred at 15 and 30 min during dialysis with all membranes but benzyl cellulose, the increase with cuprophan being higher than with the other membranes. In concomitance with the increase in platelet-neutrophil coaggregation, an increased hydrogen peroxide production by neutrophils occurred, which proved to be significantly higher compared to the unchanged neutrophil hydrogen peroxide production during HD with benzyl cellulose.


CONCLUSIONS
Our results demonstrate that derivatised cellulose is associated with a considerable improvement in the clinical biocompatibility profile. Derivatised cellulosic membranes show many similarities but also several significant differences which very likely stem from the different type of structural modification to the cellulose polymer rather than from the degree of hydroxyl group replacement.
Bonomini
M
M
Institute of Nephrology, Department of Medicine, 'G. D'Annunzio' University, Chieti, Italy. M.Bonomini@nephro.unich.it
Sirolli
V
V
Settefrati
N
N
Stuard
S
S
Tropea
F
F
Di Liberato
L
L
Tetta
C
C
Albertazzi
A
A
D000328:Adult; D000368:Aged; D016824:Antigens, Human Platelet; D018845:CD11 Antigens; D018821:CD18 Antigens; D002448:Cell Adhesion; D006801:Humans; D007674:Kidney Diseases / Q000097:blood / Q000473:pathology / Q000628:therapy; D008875:Middle Aged; D018375:Neutrophil Activation; D018384:Oxidative Stress; D015539:Platelet Activation; D017382:Reactive Oxygen Species / Q000378:metabolism; D006435:Renal Dialysis / Q000009:adverse effects
D016824:Antigens, Human Platelet; D018845:CD11 Antigens; D018821:CD18 Antigens; D017382:Reactive Oxygen Species