title: Potential role of the soluble form of CD40 in deficient immunological function of dialysis patients: new findings of its amelioration using polymethylmethacrylate (PMMA) membrane.
abstract: Even though numerous studies have helped to better delineate abnormalities of either innate or adaptive immune system in end-stage renal disease (ESRD) patients, understanding immune dysfunctions in ESRD patients remains a very complex puzzle with missing pieces. In this context, we showed that the soluble form of CD40 (sCD40) is elevated in ESRD patients and is associated with a lack of response to hepatitis B vaccination. Interestingly, although most dialysis membranes are unable to clear sCD40, we demonstrated that polymethylmethacrylate (PMMA) BK-F membranes (Toray Medical Company, Japan) allow a dramatic diminution of the molecule. We took advantage of this observation to address the question of the potential usefulness of PMMA membrane (BK-F series) in the improvement of humoral immune response of ESRD patients. We, thus, present our recent data highlighting the potential role of BK-F membrane in the improvement of hepatitis B vaccination of ESRD patients who failed to mount a protective immune response despite one or more well-conducted anterior vaccination. Taken as a whole, our findings reinforced the concept of seeing dialysis membranes not just as a simple diffusive device but as a tool to tailor dialysis procedure to improve the global quality of life of ESRD patients. This opens a wide area of investigation, notably for the management of immunological dysfunction of ESRD patients.
authors.affiliation: UMR-CNRS 5164 CIRID, Université Victor Segalen, Bordeaux, France; Department of Immunology, Pellegrin Hospital, Bordeaux, France.
authors.forename: Cécile
authors.initials: C
authors.lastname: Contin-Bordes
authors.affiliation: Department of Nephrology , Pellegrin Hospital , Bordeaux , France.
authors.forename: Adeline
authors.initials: A
authors.lastname: Lacraz
authors.affiliation: Department of Nephrology , Pellegrin Hospital , Bordeaux , France.
authors.forename: Valérie
authors.initials: V
authors.lastname: de Précigout
keywords: haemodialysis; hepatitis B vaccination; immune dysfunctions; polymethylmethacrylate (PMMA) membrane; soluble CD40