title: Effects of ethylene oxide and steam sterilization on dialysis-induced cytokine release by cuprophan membrane.
abstract: The effects of sterilization modalities on dialysis-induced cytokine release are still unknown. To investigate these effects, 8 patients on chronic hemodialysis were enrolled for evaluating at different intervals interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) production (pg/ml/106). They were using a 1.3 m2 ethylene oxide (E3) or steam (E3S) sterilized Cuprophan membrane. The patients underwent a basal test with E3 (A1) and 2 following tests after 1 (B1) and 2 (B2) months of E3S treatment, respectively. Finally, the last test was performed 1 month after the switch to E3 (A2). Il-1beta predialysis release by mononuclear cells was 162 +/- 114 pg/ml/106 in A1, 185 +/- 129 pg/ml/106 in B1, and 226 +/- 138 pg/ml/106 in B2, then decreased to 123 +/- 134 in A2 (p < 0.07). Il-1beta postdialysis levels were 234 +/- 238 pg/ml/106 in A1, 429 +/- 285 pg/ml/106 (B1), and 438 +/- 473 pg/ml/106 (B2) with the steam membrane, decreasing to 204 +/- 134 pg/ml/106 in A2 (p < 0.01). TNF-alpha predialysis basal release (A1) was 826 +/- 817 pg/ml/106, 720 +/- 496 in B1, and 1079 +/- 515 pg/ml/106 in B2, and finally 680 +/- 588 pg/ml/106 in A2 (p < 0.03). In postdialysis TNF-alpha levels were 963 +/- 542 pg/ml/106 in A1, 1,226 +/- 541 pg/ml/106, and 1,183 +/- 776 in B1 and B2 respectively, and 388 +/- 297 pg/ml/106 in A2 (p < 0.003). Steam sterilization seems to induce a higher cytokine release by mononuclear cells when a Cuprophan membrane is used. This finding may be related to a less physiologic action of the steam in the case of Cuprophan membranes. Further studies are needed to clarify this hypothesis.
authors.affiliation: Department of Nephrology and Dialysis, Casa Sollievo della Sofferenza Hospital-Istituto di Ricovero e Cura a Carattere Scientifico, San Giovanni Rotondo (FG), Italy. faucel@tin.it
authors.forename: Filippo
authors.initials: F
authors.lastname: Aucella
authors.forename: Mimmo
authors.initials: M
authors.lastname: Vigilante
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gatta
authors.forename: Elvira
authors.initials: E
authors.lastname: Grandone
authors.forename: Donatella
authors.initials: D
authors.lastname: Colaizzo
authors.forename: Maurizio
authors.initials: M
authors.lastname: Margaglione
authors.forename: Sergio
authors.initials: S
authors.lastname: Modoni
authors.forename: Carmine
authors.initials: C
authors.lastname: Stallone
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials; D002482:Cellulose / Q000031:analogs & derivatives*; D016207:Cytokines / Q000032:analysis* / Q000187:drug effects*; D003956:Dialysis; D004202:Disinfectants / Q000494:pharmacology*; D005027:Ethylene Oxide / Q000494:pharmacology*; D006801:Humans; D007375:Interleukin-1 / Q000032:analysis; D008567:Membranes, Artificial; D008875:Middle Aged; D013227:Steam; D013242:Sterilization; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014511:Uremia / Q000628:therapy*
chemical_list: D001672:Biocompatible Materials; D016207:Cytokines; D004202:Disinfectants; D007375:Interleukin-1; D008567:Membranes, Artificial; D013227:Steam; D014409:Tumor Necrosis Factor-alpha; D002482:Cellulose; C009865:cuprammonium cellulose; D005027:Ethylene Oxide