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Neutrophil adhesion molecules in chronic hemodialysis patients
P Zachée1, R Daelemans, P Pollaris
1Department of Hematology, University Hospital Gasthuisberg, Leuven, Belgium.
Insights
Neutrophil adhesion molecules change during hemodialysis. Chronic hemodialysis patients show altered Mac-1 and LAM-1 expression even before dialysis, independent of dialysis membrane type or rHuEPO treatment.
Area of Science:
- Immunology
- Nephrology
- Hematology
Background:
- Neutrophil activation and adhesion molecule expression are critical in inflammatory processes.
- Chronic hemodialysis (CHD) patients exhibit altered immune responses.
- Adhesion molecules like LFA-1, Mac-1, and LAM-1 play key roles in neutrophil function.
Purpose of the Study:
- To investigate the expression of LFA-1, Mac-1, and LAM-1 on neutrophils in chronic hemodialysis patients.
- To compare neutrophil adhesion molecule expression before and during hemodialysis.
- To assess the influence of interdialytic time and rHuEPO treatment on these molecules.
Main Methods:
- Flow cytometry was used to analyze neutrophil adhesion molecule expression.
- Samples were collected from 10 CHD patients and age-matched controls.
- Comparisons were made between predialysis and intradialysis samples, considering different interdialytic periods and rHuEPO treatment.
Main Results:
- CD11a expression remained unchanged between CHD patients and controls.
- Hemodialysis caused a transient reduction in LAM-1 expression.
- Mac-1 expression significantly increased during and after hemodialysis, while LAM-1 showed a significant downregulation predialysis.
- Predialysis neutrophils in CHD patients exhibited a 'high Mac-1, low LAM-1' phenotype, irrespective of interdialytic time or rHuEPO use.
Conclusions:
- The 'high Mac-1, low LAM-1' neutrophil phenotype in CHD patients is not solely a dialysis-induced phenomenon but is present before the hemodialysis session.
- Hemodialysis itself induces transient changes in LAM-1 and sustained increases in Mac-1 expression.
- Interdialytic time and rHuEPO treatment did not significantly influence this observed neutrophil phenotype.
Abstract:
The expression of the adhesion molecules LFA-1 (CD11a-CD18), Mac-1 (CD11b-CD18), and LAM-1 on predialysis and intradialysis neutrophils (PMN) was analyzed by flow cytometry in 10 chronic hemodialysis patients (CHD) and compared with age-matched normal controls. All patients were dialyzed either with a polyacrylonitrile, or a polysulfone membrane. To appreciate the influence of the interdialytic time, we compared the samples of Monday (3 days without dialysis), with those of Wednesday (2 days without dialysis). A patient group not treated with recombinant human erythropoietin (rHuEPO) was also included to analyze the influence of r-HuEPO. We found on the predialysis and intradialysis samples that the expression of CD11a was not different in the CHD patients and in the normal controls. Hemodialysis was associated with a rapid and significant reduction in LAM-1 on the 15- and 30-min samples (p < 0.05). This reduction was only transient, and returned to near predialysis levels after 120 min dialysis. The MAC-1 increased significantly after 30 min dialysis (p < 0.01), and remained at the end of the dialysis procedure still substantially above the predialysis levels (p < 0.01). On the other hand, we have found a significant (p < 0.005) up-regulating of the MAC-1, and a down-regulating of the LAM-1 in the predialysis samples. We noticed further a significantly lower expression (82 +/- 9.6%) for LAM-1 in these predialysis samples (p < 0.005). These results demonstrate that 'high MAC-1, low LAM-1' neutrophils were not only a dialysis-related phenomenon, but that they were already present before the hemodialysis session, nor was there any difference between the interdialytic times or compared with the r-HuEPO treatment.