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In vitro production of tumor necrosis factor by monocytes cultured from dialysis patients
J J Ryan1, H L Beynon, A J Rees
1Department of Medicine, Royal Postgraduate Medical School, London, England, United Kingdom.
Abstract:
Cellular release of cytokines may be responsible for certain complications of extracorporeal dialysis including the increased susceptibility to infection found in dialysis patients. In order to study this further, we have evaluated the in vitro production of tumor necrosis factor (TNF) by peripheral blood monocytes (PBMC) to stimulation by lipopolysaccharide (LPS) from dialysis patients with end-stage renal failure (ESRF). The patients were subdivided into two groups according to the type of dialysis; those undergoing hemodialysis (HD) (N = 12) and those performing continuous ambulatory peritoneal dialysis (CAPD) (N = 9). Results were compared with those of controls taken from healthy laboratory staff (N = 7). The experiments show that the secretion of TNF by PBMC's in response to LPS is significantly augmented in patients undergoing HD when compared to those on CAPD (81.3 +/- 38.7 U/ml vs. 18.2 + 13.3 U/ml, mean +/- SD, P < 0.001); and controls (81.3 +/- 38.7 U/ml vs. 18.1 +/- 6.6 U/ml, P < 0.001). There was no significant difference between the CAPD group and controls. In vitro monocyte production of TNF fell following a single HD session (81.3 +/- 38.7 U/ml before HD and 50.5 +/- 28.7 U/ml after HD, P < 0.05). We conclude from this study that TNF release from PBMC's in vitro is augmented in patients with chronic renal failure receiving chronic HD but not in a similar group receiving CAPD. Interestingly, TNF release from monocytes collected immediately following a dialysis was suppressed.(ABSTRACT TRUNCATED AT 250 WORDS)
Insights
Patients on hemodialysis (HD) show increased tumor necrosis factor (TNF) production compared to continuous ambulatory peritoneal dialysis (CAPD) patients and healthy controls. This suggests TNF release may contribute to infections in HD patients, with levels decreasing post-dialysis.
Area of Science:
- Immunology
- Nephrology
- Cell Biology
Background:
- Cytokine release, including tumor necrosis factor (TNF), is implicated in dialysis complications like infection susceptibility.
- End-stage renal failure (ESRF) patients undergoing dialysis present a unique immunological profile.
- Understanding monocyte activation in ESRF is crucial for managing patient health outcomes.
Purpose of the Study:
- To investigate in vitro tumor necrosis factor (TNF) production by peripheral blood monocytes (PBMC) in response to lipopolysaccharide (LPS).
- To compare TNF production in patients undergoing hemodialysis (HD) versus continuous ambulatory peritoneal dialysis (CAPD).
- To assess the impact of a single hemodialysis session on monocyte TNF production.
Main Methods:
- Peripheral blood monocytes (PBMC) were isolated from ESRF patients (HD and CAPD groups) and healthy controls.
- PBMC were stimulated with lipopolysaccharide (LPS) to induce cytokine production.
- In vitro TNF levels were measured using standardized assays.
- Monocyte TNF production was assessed before and after a hemodialysis session.
Main Results:
- Significantly augmented TNF secretion by PBMC in response to LPS was observed in HD patients compared to CAPD patients (P < 0.001).
- HD patients showed significantly higher TNF levels than healthy controls (P < 0.001), while CAPD patients did not differ significantly from controls.
- In vitro monocyte TNF production decreased significantly following a single HD session (P < 0.05).
Conclusions:
- TNF release from PBMC is elevated in chronic renal failure patients undergoing chronic HD, but not in those on CAPD.
- The augmented TNF release in HD patients may contribute to increased infection susceptibility.
- Monocyte TNF release is suppressed immediately following a hemodialysis session.