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Effect of hemodialysis on peripheral blood monocyte tumor necrosis factor-alpha, interleukin-6, and interleukin-8
I Engelberts1, G J Francot, K M Leunissen
1Department of Surgery, University of Limburg, Maastricht, The Netherlands.
Abstract:
The influence of blood-membrane interaction on human peripheral blood monocyte tumor necrosis factor-alpha (TNF), interleukin-6 (IL-6), and interleukin-8 (IL-8) secretion was measured during hemodialysis of end-stage renal disease patients by in vitro stimulation of whole blood with lipopolysaccharide. Monocyte TNF and IL-6 secretion in vitro was reduced 30 min after start of dialysis session. In contrast, cellular IL-8 secretion did not change during hemodialysis. Comparison of the results of three different membranes indicates that the bioincompatibility of the dialysis membrane was reflected in both leukocytopenia and reduction of cellular TNF secretion. During treatment of normal whole blood in an ex vivo dialysis closed-loop circuit, the ability of monocytes to release TNF, IL-6, and IL-8 in vitro remained constant. This indicates that the reduced IL-6 and TNF secretion during standard hemodialysis was not due to a direct effect of contact between dialysis membranes and monocytes, but rather was a result of redistribution within the patients' leukocyte pool.
Insights
Hemodialysis reduces monocyte tumor necrosis factor-alpha (TNF) and interleukin-6 (IL-6) secretion, but not interleukin-8 (IL-8). Dialysis membrane bioincompatibility correlates with leukocytopenia and reduced TNF secretion, suggesting leukocyte redistribution, not direct membrane effects.
Area of Science:
- Immunology
- Nephrology
- Biomaterials
Background:
- Hemodialysis is crucial for end-stage renal disease (ESRD) patients.
- Blood-membrane interactions during dialysis can trigger inflammatory responses.
- Monocyte-derived cytokines, including TNF, IL-6, and IL-8, play key roles in inflammation.
Purpose of the Study:
- To investigate the impact of hemodialysis on monocyte cytokine secretion (TNF, IL-6, IL-8).
- To assess the role of blood-membrane interaction in modulating these inflammatory responses.
- To differentiate between direct membrane effects and systemic changes in leukocyte populations.
Main Methods:
- In vitro stimulation of whole blood with lipopolysaccharide (LPS) from ESRD patients undergoing hemodialysis.
- Measurement of TNF, IL-6, and IL-8 secretion by monocytes at baseline and 30 minutes into dialysis.
- Comparison of cytokine secretion using three different dialysis membranes.
- Ex vivo closed-loop dialysis circuit with normal whole blood.
Main Results:
- Monocyte TNF and IL-6 secretion were significantly reduced 30 minutes after initiating hemodialysis.
- Interleukin-8 (IL-8) secretion remained unchanged during hemodialysis.
- Dialysis membrane bioincompatibility correlated with leukocytopenia and reduced TNF secretion.
- Ex vivo experiments showed no change in monocyte cytokine release upon direct membrane contact.
Conclusions:
- Reduced IL-6 and TNF secretion during hemodialysis is primarily due to leukocyte redistribution within the patient's pool, not direct effects of dialysis membranes.
- Dialysis membrane bioincompatibility influences leukocytopenia and TNF secretion, highlighting the importance of membrane material selection.
- Understanding these immune modulations is crucial for improving hemodialysis patient outcomes and biocompatibility.