Formaldehyde in the pathogenesis of hemodialysis-related anti-N antibodies

The role of formaldehyde (CH2O) in the pathogenesis of anti-N-like antibodies found in patients on chronic hemodialysis was investigated. In vitro studies were performed by incubating MM cells in varying concentrations of CH2O for variable time periods, corresponding to conditions that occur in dialysis. This MM cells acquired reactivity to anti-N antibody. The antigenic shift is felt to occur from the interaction of CH2O with the terminal N-acetylneuraminic acid (sialic acid) groups of M substance, resulting in the exposure to an altered-N antigen that is immunogenically active. Through a similar mechanism, CH2O may also directly modify N substance.