Comparison of the effects of cellulose triacetate and polysulfone membrane on GPIIb/IIIa and platelet activation.
BACKGROUND
During hemodialysis session, several adverse reactions can occur on platelets, which are attributable to bioincompatibility of the dialysis membrane. Glycoprotein IIb/IIIa (GPIIb/IIIa) is the receptor for fibrinogen, which mediates platelet aggregation and adhesion. Accordingly, we compared the influence of a cellulose triacetate (CTA) and polysulfone (PS) membrane on GPIIb/IIIa and platelet activation.


METHODS
Blood samples from 5 patients on hemodialysis were taken at 0 time, 15 min, 30 min, 60 min and 240 min, during a single hemodialysis session, by a crossover design using CTA or PS. Platelet count and plasma concentration of GPIIb/IIIa, beta-thromboglobulin (beta-TG) and platelet factor 4 (PF-4) were measured. GPIIb/IIIa was measured by flow cytometry. beta-TG and PF-4 were measured by ELISA.


RESULTS
There was no significant change in the total amount of GPIIb/IIIa during dialysis session between the CTA and PS. However, the level of bound GPIIb/IIIa was significantly (p < 0.0002) increased from 1,426 +/- 435 to 40,446 +/- 2,777 mol/PLT with PS. In contrast, there was no significant change with CTA (3,258 +/- 1,469 to 4,301 +/- 1,422 mol/PLT). The platelet counts and beta-TG and PF-4 behavior during the dialysis session did not show significant change between the PS and CTA.


CONCLUSIONS
The characterization of changes in platelet membrane receptor (GPIIb/IIIa) may be a useful marker for studying the biocompatibility of dialysis membranes. On platelet aggregation, CTA might be more biocompatible membrane than PS.
Kuragano
Takahiro
T
Second Department of Internal Medicine, Nihon University School of Medicine, Tokyo, Japan. kuragano@med.nihon-u.ac.jp
Kuno
Tsutomu
T
Takahashi
Yoshiko
Y
Yamamoto
Chii
C
Nagura
Yuji
Y
Takahashi
Susumu
S
Kanmatsuse
Katsuo
K
D000328:Adult; D001672:Biocompatible Materials / Q000494:pharmacology*; D002482:Cellulose / Q000031:analogs & derivatives* / Q000494:pharmacology*; D018592:Cross-Over Studies; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood / Q000628:therapy; D008297:Male; D008422:Materials Testing; D008567:Membranes, Artificial; D008875:Middle Aged; D015539:Platelet Activation / Q000187:drug effects*; D010976:Platelet Count; D010978:Platelet Factor 4 / Q000032:analysis; D019039:Platelet Glycoprotein GPIIb-IIIa Complex / Q000032:analysis / Q000187:drug effects*; D011108:Polymers / Q000494:pharmacology*; D006435:Renal Dialysis / Q000009:adverse effects / Q000295:instrumentation*; D013450:Sulfones / Q000494:pharmacology*; D013927:Thrombosis / Q000209:etiology / Q000517:prevention & control; D001620:beta-Thromboglobulin / Q000032:analysis
D001672:Biocompatible Materials; D008567:Membranes, Artificial; D019039:Platelet Glycoprotein GPIIb-IIIa Complex; D011108:Polymers; D013450:Sulfones; D001620:beta-Thromboglobulin; C017662:polysulfone P 1700; D010978:Platelet Factor 4; D002482:Cellulose; C024671:cellulose triacetate