Platelet GPIIb/IIIa is activated and platelet-leukocyte coaggregates formed in vivo during hemodialysis.
OBJECTIVE
During hemodialysis, platelets and leukocytes are activated and form platelet-leukocyte coaggregates in which GPIIb/IIIa (CD41/CD61) and CD62P (P-selectin) are involved. However, it is still controversial whether platelet activation and platelet-leukocyte coaggregate formation are dependent on the dialyzer membrane material.


METHODS
We examined the appearance of activation-dependent antibody on platelets as an index of platelet activation, and the appearance of platelet-specific antigen on leukocytes as an index of platelet-leukocyte coaggregation, during hemodialysis in 7 patients treated using regenerated cellulose (RC) membrane and next using polysulfone (PS) membrane. In order to reduce the influence of factors other than dialyzer membrane material, this study was conducted in a prospective crossover fashion using a pyrogen-free bicarbonate dialysate. Moreover, flow cytometric techniques with whole blood were employed, which reduce artificial cell activation during the cell or plasma separation procedure. The platelet-specific monoclonal antibodies used in this study were anti-CD61, PAC-1 (which recognizes only the conformationally activated GPIIb/IIIa) and anti-CD62P.


RESULTS
Changes in the percentage of PAC-1-positive platelets were significantly greater during hemodialysis with RC than with PS. However, changes in the percentage of CD62P-positive platelets were not significantly different between hemodialysis with RC and PS. Changes in the percentage of CD61- or CD62P-positive leukocytes were significantly greater during hemodialysis with RC than with PS. Although changes in percentage of PAC-1-positive platelets did not parallel those of CD62P-positive platelets during hemodialysis, there was a significant positive correlation between the percentage of CD61-positive leukocytes and the percentage of CD62P-positive leukocytes.


CONCLUSIONS
This study, conducted in a prospective crossover fashion using a pyrogen-free bicarbonate dialysate in order to reduce the influence of factors other than the dialyzer membrane material, demonstrated that both the degrees of GPIIb/IIIa activation and platelet-leukocyte coaggregation were greater during hemodialysis with RC than PS.
Kawabata
Kenji
K
Department of Internal Medicine, Daiko Medical Center, Nagoya University School of Medicine, Daiko-minami, Higashi-ku, Japan.
Nakai
Shigeru
S
Miwa
Masamiki
M
Sugiura
Tatsuki
T
Otsuka
Yuka
Y
Shinzato
Toru
T
Hiki
Yoshiyuki
Y
Tomimatsu
Ikuko
I
Ushida
Yumi
Y
Hosono
Fumiko
F
Maeda
Kenji
K
D000328:Adult; D000368:Aged; D000911:Antibodies, Monoclonal / Q000276:immunology / Q000378:metabolism; D001792:Blood Platelets / Q000276:immunology / Q000378:metabolism*; D018592:Cross-Over Studies; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007962:Leukocytes / Q000276:immunology / Q000378:metabolism*; D008297:Male; D008875:Middle Aged; D019007:P-Selectin / Q000378:metabolism*; D015539:Platelet Activation / Q000502:physiology; D010974:Platelet Aggregation / Q000502:physiology*; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000378:metabolism*; D011446:Prospective Studies; D006435:Renal Dialysis / Q000295:instrumentation; D013223:Statistics as Topic
D000911:Antibodies, Monoclonal; D019007:P-Selectin; D019039:Platelet Glycoprotein GPIIb-IIIa Complex