Three monocyte-related determinants of atherosclerosis in haemodialysis.
BACKGROUND
It has been suggested that monocyte-related inflammatory mediators play a role in atherosclerosis. Haemodialysis induces phenotypic changes in adhesion molecule expression on monocytes. Soluble vascular cell adhesion molecule-1 (sVCAM-1), an adhesion molecule involved in monocyte recruitment, has been proposed to correlate with the extent of atherosclerosis in humans. Monocyte chemotactic protein-1 (MCP-1) functions as a monocyte-specific chemoattractant.


METHODS
We studied monocyte count, CD11b/CD18 expression on monocytes, MCP-1, and sVCAM-1 in nine patients on either cuprophane or polysulphone haemodialysis (n=18 treatments) at times 0 (before haemodialysis), 3 h (end of haemodialysis), 4, 6, 8 and 24 h after start of treatment, as well as in 18 healthy subjects.


RESULTS
Monocyte CD11b/CD18 expression increased with both membranes (P:<0.001) during and after dialysis compared to before treatment. The concentrations of sVCAM-1 and MCP-1 were higher in patients compared to those in controls both before, during and after haemodialysis (P:<0.001 at all time points). There were correlations between the expression of CD11b/CD18 on monocytes and the interdialytic concentrations of sVCAM-1 (r=0.76, P:<0.001) and MCP-1 (r=0.54, P:<0.05) and between MCP-1 and sVCAM-1 before and after haemodialysis (P:<0.05).


CONCLUSIONS
Patients on haemodialysis have an increased systemic chemotactic activity for monocytes, unphysiological phenotypic alterations in CD11b/ CD18 expression during and after dialysis, and increased sVCAM-1 and MCP-1 concentrations. Prospective studies are needed to establish the role of these abnormalities in the pathogenesis of atherosclerosis in haemodialysis patients.
Jacobson
S H
SH
Departments of Nephrology, Karolinska Hospital and Karolinska Institute, Stockholm, Sweden.
Thylén
P
P
Lundahl
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001161:Arteriosclerosis / Q000209:etiology*; D018821:CD18 Antigens / Q000097:blood / Q000502:physiology; D018932:Chemokine CCL2 / Q000097:blood / Q000502:physiology; D005260:Female; D006801:Humans; D016177:Macrophage-1 Antigen / Q000097:blood / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D006435:Renal Dialysis / Q000009:adverse effects*; D012995:Solubility; D019010:Vascular Cell Adhesion Molecule-1 / Q000097:blood / Q000502:physiology
D018821:CD18 Antigens; D018932:Chemokine CCL2; D016177:Macrophage-1 Antigen; D019010:Vascular Cell Adhesion Molecule-1