SYNTHESIS OF BETA(2)-MICROGLOBULIN IN LYMPHOCYTE CULTURE - ROLE OF HEMODIALYSIS, DIALYSIS MEMBRANES, DIALYSIS-AMYLOIDOSIS, AND LYMPHOKINES

Dialysis-amyloidosis (Aβ2M) is a recently recognized chronic complication in long-term dialysis patients, apparently effecting 5% to 10% of all dialysis patients. In 1985, Gejyo et al (Biochem Biophys Res Commun 129:701-706,1085) and Shirahama et al (Lab Invest 53:705-709,1985) identified β2-Microglobulin (β2-M) as the major constituent protein of this unique type of systemic amyloidosis. The specific pathogenesis of Aβ2M remains unknown, although β2-M has been clearly identified as playing a central role as the amyloidogenic protein. To investigate the factors responsible for in vitro β2-M synthesis, we studied β2-M production by lymphocyte cultures obtained from dialysis patients and grown under a variety of different conditions, and compared the results to a control group of subjects with normal renal function. We could not demonstrate any stimulatory influence on β2-M synthesis by the hemodialysis treatment, the type of dialysis membrane used, or the clinical presence of Aβ2M. Rather, dialysis membranes, sterilized with ethylene oxide or gamma rays, added to the lymphocyte cultures exerted a strong dose-dependent inhibitory effect on β2-M synthesis. From the results of this study, we conclude that peripheral blood lymphocytes in uremic patients synthesize β2-M normally and that the direct interaction between circulating lymphocytes and the dialysis membrane that occurs during hemodialysis does not seem to contribute directly to β2-M synthesis. © 1993, National Kidney Foundation. All rights reserved. All rights reserved.