title: The effect of hydroxyethyl starches (HES 130/0.42 and HES 200/0.5) on activated renal tubular epithelial cells.
abstract: BACKGROUND
  Acute renal failure is a frequent complication of sepsis. Hydroxyethyl starch (HES) is widely used in the treatment of such patients. However, the effect of HES on renal function during sepsis remains controversial. We established an in vitro model of tumor necrosis factor-alpha (TNF-alpha)-stimulated human proximal tubular epithelial (HK-2) cells to assess the possible effects of HES 130/0.42 and HES 200/0.5 on these activated cells.
  
  
  METHODS
  HK-2 cells were stimulated with TNF-alpha in the presence or absence of HES 130/0.42 or 200/0.5. After 4, 10, and 18 h of incubation, monocyte chemoattractant protein-1 (MCP-1), a key chemoattractant for neutrophils and macrophages, was measured. In addition, viability and cytotoxicity assays were performed.
  
  
  RESULTS
  MCP-1 expression was doubled upon TNF-alpha exposure. In the presence of 2% and 4% HES 200/0.5 in 98% (96%) medium over a stimulation time period of 10 h and 18 h, the MCP-1 concentration was decreased between 26% and 56% (P < 0.05). TNF-alpha stimulation resulted in a significant decrease of viability by 53%-63%, whereas viability decreased by only 32%-40% in coincubation with HES 130/0.42 (P < 0.005) and remained even less affected by TNF-alpha in the presence of HES 200/0.5 (P < 0.001). The TNF-alpha-induced cell death rate was attenuated in the presence of HES 200/0.5 (P < 0.05).
  
  
  CONCLUSIONS
  This in vitro study shows that both HES products modulate cell injury upon inflammatory stimulation. The effect was more pronounced in the HES 200/0.5 group than for HES 130/0.42, suggesting a possible biological difference between the HES types.
authors.affiliation: Institute of Anesthesiology, University of Zurich, Zurich, Switzerland.
authors.forename: Moritz
authors.initials: M
authors.lastname: Wittlinger
authors.forename: Martin
authors.initials: M
authors.lastname: Schläpfer
authors.forename: Elisena
authors.initials: E
authors.lastname: De Conno
authors.forename: Birgit Roth
authors.initials: BR
authors.lastname: Z'graggen
authors.forename: Livia
authors.initials: L
authors.lastname: Reyes
authors.forename: Christa
authors.initials: C
authors.lastname: Booy
authors.forename: Ralph C
authors.initials: RC
authors.lastname: Schimmer
authors.forename: Burkhardt
authors.initials: B
authors.lastname: Seifert
authors.forename: Marc-Alexander
authors.initials: MA
authors.lastname: Burmeister
authors.forename: Donat R
authors.initials: DR
authors.lastname: Spahn
authors.forename: Beatrice
authors.initials: B
authors.lastname: Beck-Schimmer
mesh_terms: D002460:Cell Line; D002470:Cell Survival / Q000187:drug effects; D002478:Cells, Cultured; D018932:Chemokine CCL2 / Q000096:biosynthesis; D004797:Enzyme-Linked Immunosorbent Assay; D004847:Epithelial Cells / Q000187:drug effects / Q000378:metabolism; D016650:Fluorescein-5-isothiocyanate; D005456:Fluorescent Dyes; D005780:Gelatin / Q000494:pharmacology; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000737:chemistry / Q000494:pharmacology*; D007249:Inflammation; D007552:Isotonic Solutions / Q000494:pharmacology; D007687:Kidney Tubules, Proximal / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D007770:L-Lactate Dehydrogenase / Q000378:metabolism; D018613:Microscopy, Confocal; D010952:Plasma Substitutes / Q000494:pharmacology*; D000077325:Ringer's Lactate; D014409:Tumor Necrosis Factor-alpha / Q000494:pharmacology
chemical_list: D018932:Chemokine CCL2; D005456:Fluorescent Dyes; D006895:Hydroxyethyl Starch Derivatives; D007552:Isotonic Solutions; D010952:Plasma Substitutes; D000077325:Ringer's Lactate; D014409:Tumor Necrosis Factor-alpha; D005780:Gelatin; C042021:physiogel; D007770:L-Lactate Dehydrogenase; D016650:Fluorescein-5-isothiocyanate