Balance between cytokine production by peripheral blood mononuclear cells and reactive oxygen species production by monocytes in patients with chronic kidney disease.
Hemodialysis (HD) and peritoneal dialysis are associated with inflammatory events and immunological incompetence. The purpose of this study was to evaluate the effect of both uremia and dialysis modality on the production of cytokines and reactive oxygen species (ROS) by monocytes. four groups of subjects were studied: 28 chronic kidney disease (CKD) patients, 14 chronic HD patients, 14 patients on continuous ambulatory peritoneal dialysis (CAPD) patients, and 14 healthy volunteers, peripheral blood mononuclear cells (PBMC) were isolated from blood samples and incubated for 24 hr with or without lipopolysaccharide (LPS). TNF-alpha and IL-10 production by PBMC and serum levels of these cytokines were quantified by ELISA. Aliquots of whole blood were incubated in vitro and ROS production and phagocytosis were quantified by flow cytometry. Compared to the control group, Staphylococcus aureus-stimulated ROS production by monocytes was significantly lower in the HD group. The highest levels of unstimulated TNF-alpha production in vitro were observed in the HD group. In the CKD group, as well as in the whole population, there were a negative correlation between TNF-alpha production by unstimulated PBMC and ROS production by S. aureus-stimulated monocytes and a positive correlation between PMA-stimulated ROS production by monocytes and unstimulated and LPS-stimulated IL-10 production by PBMC suggesting that the pro-inflammatory state in CKD patients is associated with decreased response to infectious challenges.
Sardenberg
Camila
C
Department of Medicine, Division of Nephrology, Universidade Federal de São Paulo-UNIFESP, São Paulo, São Paulo, Brazil. cendoro@uol.com.br
Suassuna
Paulo
P
Watanabe
Renato
R
Cruz Andreoli
Maria Cláudia
MC
Aparecida Dalboni
Maria
M
Faria Seabra
Victor
V
Draibe
Sérgio Antonio
SA
Cendoroglo Neto
Miguel
M
Jaber
Bertrand
B
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D016207:Cytokines / Q000032:analysis / Q000378:metabolism*; D005260:Female; D006801:Humans; D007676:Kidney Failure, Chronic / Q000097:blood* / Q000175:diagnosis / Q000628:therapy; D007677:Kidney Function Tests; D007963:Leukocytes, Mononuclear / Q000378:metabolism*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009000:Monocytes / Q000378:metabolism*; D010531:Peritoneal Dialysis, Continuous Ambulatory; D011336:Probability; D011379:Prognosis; D017382:Reactive Oxygen Species / Q000032:analysis / Q000378:metabolism*; D012016:Reference Values; D006435:Renal Dialysis; D018570:Risk Assessment; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D016896:Treatment Outcome
D015415:Biomarkers; D016207:Cytokines; D017382:Reactive Oxygen Species