HEMODIALYSIS-ASSOCIATED INDUCTION OF CYTOKINES

被引：76

作者：

LONNEMANN, G

HAUBITZ, M

SCHINDLER, R

机构：

[1] Abteilung Nephrologie, Medizinische Hochschule Hannover, Hannover

来源：

BLOOD PURIFICATION | 1990年 / 8卷 / 04期

关键词：

Cytokines; Dialyzer membrane; End–stage renal disease; Hemodialysis; Interleukins; Mononuclear cells; Tumor necrosis factor;

D O I：

10.1159/000169969

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

The interleukin hypothesis relates chronic pathology in long-term end-stage renal disease (ESRD) patients to repeated stimulation of mononuclear cell cytokine production during hemodialysis.In vitro experiments demonstrated different possible mechanisms involved in hemodialysis-associated cytokine induction: adherence of mononuclear cells to the dialyzer membrane; complement activation, and the passage of cytokine-inducing bacterial fragments from contaminated dialysate through thedialyzer membrane into the blood. Studies investigating mononuclear cells from ESRD patients ex vivo suggest that these cells become activated during hemodialysis with complement-activating membranes and that the type of dialyzer membrane may influence mononuclear cell cytokine production in response to endotoxin. According to biological assays, plasma levels of interleukin-1 but not interleu-kin-6 activity seem to be elevated in ESRD patients compared to normal subjects and may increase further during treatment depending on the choice of the dialyzer membrane. However, to date, partly due to insufficient assay sensitivity and circulating inhibitors, measurements of interleukin-1, interleukin-6 and tumor necrosis factor in plasma by specific immunoassays could not finally prove elevated plasma cytokine levels in ESRD patients. Since circulating mononuclear cells are a major source of cytokines, studying the activation of these cells ex vivo seems to be the best approach to study hemodialysis-associated cytokine induction. © 1990 S. Karger AG, Basel.

引用

页码：214 / 222

页数：9

共 33 条

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