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Bio-incompatibility and Th2 polarization during regular dialysis treatment
Carmelo Libetta1, Vincenzo Sepe, Antonio Dal Canton
1Unit of Nephrology, Dialysis, Transplantation, Fondazione I.R.C.C.S. San Matteo Hospital, Pavia, Italy, and University of Pavia, Pavia, Italy.
International Reviews of Immunology
|November 16, 2010
Summary
Long-term hemodialysis can cause immune issues. Synthetic or vitamin E coated membranes may improve hemodialysis tolerance and reduce immune complications compared to cellulose membranes.
Area of Science:
- Nephrology
- Immunology
- Biomaterials Science
Background:
- Long-term hemodialysis (HD) is linked to chronic monocyte activation and cytokine release.
- This process can lead to T-regulatory cell (Treg) induction, immune dysfunction, and clinical complications.
- Emerging evidence suggests improved HD tolerance with synthetic or vitamin E coated membranes over cellulose.
Purpose of the Study:
- To review and update current knowledge on cytokine release during hemodialysis.
- To examine T-cell polarization in patients undergoing extracorporeal hemodialysis.
- To compare the clinical impact of cellulose membranes versus synthetic/vitamin E coated membranes on hemodialysis tolerance and immune response.
Main Methods:
- Literature review of immunological data and clinical evidence.
- Comparative analysis of hemodialysis membranes (cellulose vs. synthetic/vitamin E coated).
- Focus on cytokine profiles and T-cell responses in patients.
Main Results:
- Synthetic and vitamin E coated membranes demonstrate significant improvements in hemodialysis tolerance.
- These advanced membranes appear to mitigate adverse immune responses associated with traditional cellulose membranes.
- Reduced chronic monocyte activation and altered cytokine release are associated with improved outcomes.
Conclusions:
- Hemodialysis membrane material significantly influences patient immune response and tolerance.
- Synthetic/vitamin E coated membranes offer a promising alternative to cellulose, potentially reducing immune dysfunction and complications.
- Further research is warranted to fully elucidate the long-term clinical benefits.
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