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Reactive oxygen species production by monocytes and polymorphonuclear leukocytes during dialysis
J Himmelfarb1, J M Lazarus, R Hakim
1Department of Medicine, University of Vermont Medical School, Maine Medical Center, Portland.
Abstract:
Intradialytic production of reactive oxygen species (ROS) by monocytes and polymorphonuclear leukocytes (PMNL) was examined separately in six hemodialysis patients. Samples obtained 15 minutes after initiation of dialysis with new cuprophane membranes demonstrated significantly increased (P less than 0.05) ROS production in both cell populations as measured by the fluorescence of a specific intracellular marker (2',7'-dichlorofluorescein diacetate [DCFH-DA]) assayed by flow cytometry. Granulocytes harvested during dialysis also showed decreased responsiveness to exogenous C5a and F-Met-Leu-Phe (FMLP) at 15, 30, and 60 minutes after initiation of dialysis (P less than 0.05). Our data suggest that hemodialysis with cuprophane membrane is associated with monocyte and PMNL activation as shown by production of ROS coincident with peak activation of the complement cascade; these granulocytes become refractory to further stimulation with C5a and FMLP during dialysis.
Insights
Hemodialysis with cuprophane membranes activates monocytes and polymorphonuclear leukocytes (PMNL), increasing reactive oxygen species (ROS) production. These activated immune cells become less responsive to further stimulation during dialysis.
Area of Science:
- Immunology
- Nephrology
- Biochemistry
Background:
- Hemodialysis is a crucial treatment for kidney failure.
- The interaction between dialysis membranes and blood cells can trigger immune responses.
- Reactive oxygen species (ROS) play a role in cellular signaling and inflammation.
Purpose of the Study:
- To investigate the intradialytic production of ROS by monocytes and polymorphonuclear leukocytes (PMNL).
- To assess the responsiveness of granulocytes to stimulation during hemodialysis.
- To understand the immune cell activation associated with cuprophane membrane hemodialysis.
Main Methods:
- Blood samples were collected from six hemodialysis patients.
- Reactive oxygen species (ROS) production was measured using 2',7'-dichlorofluorescein diacetate (DCFH-DA) and flow cytometry.
- Cellular responsiveness to C5a and F-Met-Leu-Phe (FMLP) was assessed at various time points during dialysis.
Main Results:
- Significant increase in ROS production by monocytes and PMNL 15 minutes after initiating dialysis with cuprophane membranes.
- Granulocytes exhibited decreased responsiveness to C5a and FMLP at 15, 30, and 60 minutes post-dialysis initiation.
- ROS production correlated with the activation of the complement cascade during hemodialysis.
Conclusions:
- Hemodialysis using cuprophane membranes induces activation of monocytes and PMNL, evidenced by ROS production.
- Activated granulocytes during hemodialysis become refractory to further stimulation.
- These findings highlight the inflammatory potential of cuprophane membranes during hemodialysis.