title: Adsorption as a Contributor for Inflammatory Mediators Removal by Different Hemofiltration Membranes: A Pilot Study.
abstract: Atherosclerosis is an important predictor of mortality in patients with chronic kidney disease (CKD) and is associated with a wide inflammatory response. The aim of this study is to evaluate in vitro how different membranes can remove mediators associated with this pathology in a closed loop dialysis model. We performed experimental hemofiltration in vitro using three different membrane materials. Human plasma was preliminarily incubated with various inflammatory mediators and filtered in a closed loop circulation model for 240 min. Respective concentrations of 17 different mediators were measured over time to study the removal mechanisms of each membrane, including associated removal time course. The experiment was repeated three times for the assay of tumor necrosis factor (TNF)-α to document the model variability. Means were compared using Mann-Whitney test. Most of the investigated mediators were effectively removed with the different dialysis membranes. Adsorption mechanism was mainly at the origin of the decrease in mediators circulating concentrations and was maximized in the region 10 000-20 000 Da. Especially, the HeprAN membrane showed fast removal capacities of mediators with elevated isoelectric point including complement factors and chemokines or having basic groups located in the protein periphery, plasminogen activator inhibitor (PAI-1), and TNF-α-like. The latter was further significantly removed with HeprAN and polymethylmethacrylate (PMMA) compared to polyethersulfone (PES) material (P < 0.01). We concluded that dialysis using ionic adsorptive membrane could have a beneficial impact for CKD patients with atherosclerosis and would deserve further clinical investigations.
authors.affiliation: MTO Department, Baxter, Meyzieu.
authors.forename: Benjamin
authors.initials: B
authors.lastname: Malard
authors.affiliation: Nephrology Department, Hospices Civils De Lyon.|Inserm CARMEN U1060, University of Lyon1, Lyon, France.
authors.forename: Nans
authors.initials: N
authors.lastname: Florens
authors.affiliation: MTO Department, Baxter, Meyzieu.
authors.forename: Corine
authors.initials: C
authors.lastname: Lambert
authors.affiliation: Nephrology Department, Hospices Civils De Lyon.|Inserm CARMEN U1060, University of Lyon1, Lyon, France.
authors.forename: Laurent
authors.initials: L
authors.lastname: Juillard
mesh_terms: D000327:Adsorption; D050197:Atherosclerosis / Q000097:blood / Q000150:complications* / Q000628:therapy; D018932:Chemokine CCL2 / Q000097:blood / Q000302:isolation & purification; D019332:Endothelin-1 / Q000097:blood / Q000302:isolation & purification; D004867:Equipment Design; D006440:Hemofiltration / Q000295:instrumentation*; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000150:complications / Q000628:therapy; D018836:Inflammation Mediators / Q000097:blood / Q000302:isolation & purification*; D008567:Membranes, Artificial; D010865:Pilot Projects; D017395:Plasminogen Activator Inhibitor 1 / Q000097:blood / Q000302:isolation & purification; D011108:Polymers / Q000737:chemistry; D019904:Polymethyl Methacrylate / Q000737:chemistry; D051436:Renal Insufficiency, Chronic / Q000097:blood / Q000150:complications* / Q000628:therapy*; D013450:Sulfones / Q000737:chemistry; D014409:Tumor Necrosis Factor-alpha / Q000097:blood / Q000302:isolation & purification
chemical_list: C111835:CCL2 protein, human; D018932:Chemokine CCL2; D019332:Endothelin-1; D018836:Inflammation Mediators; D008567:Membranes, Artificial; D017395:Plasminogen Activator Inhibitor 1; D011108:Polymers; D013450:Sulfones; D014409:Tumor Necrosis Factor-alpha; C022840:polyether sulfone; D019904:Polymethyl Methacrylate
keywords: -Atherosclerosis; -Clearance; -Dialysis; -Membranes; Adsorption