补体和血小板活化因子在血液透析过程中对吞噬作用和活性氧生成的刺激作用。

Role of complement and platelet-activating factor in the stimulation of phagocytosis and reactive oxygen species production during haemodialysis.

作者信息

Gastaldello K, Husson C, Wens R, Vanherweghem J L, Tielemans C

机构信息

Department of Nephrology, Dialysis and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.

出版信息

Nephrol Dial Transplant. 2000 Oct;15(10):1638-46. doi: 10.1093/ndt/15.10.1638.

DOI:10.1093/ndt/15.10.1638

PMID:11007834

Abstract

BACKGROUND

Neutrophil phagocytic functions have been studied extensively in haemodialysis (HD) patients; however, results are contradictory and the mechanisms that modulate phagocytosis and oxidative burst during dialysis are not completely understood.

METHODS

The present study investigated neutrophil functions in a selected population of patients before and during clinical dialysis with cuprophane, and polyacrylonitrile (AN69) membranes. We measured phagocytosis of Escherichia coli and intracellular hydrogen peroxide (H2O2) production by flow cytometry in whole blood.

RESULTS

Before dialysis, neutrophils from HD patients showed normal phagocytic capability and H2O2 formation. Phagocytosis of FITC-E. coli was significantly stimulated in cuprophane but not AN69-treated patients. Spontaneous and stimulated H2O2 production was enhanced with both cuprophane and AN69 membranes. We then investigated in vitro the role of complement and platelet-activating factor (PAF) in the activation of neutrophils. Incubation of whole blood with C5a increased phagocytosis but not H2O2 production. On the contrary, the addition of synthetic PAF showed a markedly stimulated H2O2 production without increase in phagocytosis. Moreover, during dialysis with formaldehyde-reused cuprophane, complement activation was abolished and phagocytosis was no longer enhanced, while the stimulation of H2O2 production persisted. In addition, we also excluded a particular role of the membrane itself in the activation of neutrophils.

CONCLUSION

We demonstrated that in a selected population of HD patients, neutrophils exhibit normal phagocytic capability and normal intracellular H2O2 production. During dialysis, the stimulation of phagocytosis observed with cuprophane is complement dependent, whereas the enhanced H2O2 production observed with both cuprophane and AN69 membranes might be related to PAF production.

摘要

背景

在血液透析（HD）患者中，中性粒细胞的吞噬功能已得到广泛研究；然而，结果相互矛盾，且透析过程中调节吞噬作用和氧化爆发的机制尚未完全明确。

方法

本研究调查了使用铜仿膜和聚丙烯腈（AN69）膜进行临床透析前及透析过程中特定患者群体的中性粒细胞功能。我们通过流式细胞术测量全血中大肠杆菌的吞噬作用和细胞内过氧化氢（H2O2）的产生。

结果

透析前，HD患者的中性粒细胞显示出正常的吞噬能力和H2O2形成。在使用铜仿膜治疗的患者中，FITC标记的大肠杆菌的吞噬作用受到显著刺激，但在使用AN69膜治疗的患者中未出现这种情况。使用铜仿膜和AN69膜时，自发和刺激产生的H2O2均增加。然后，我们在体外研究了补体和血小板活化因子（PAF）在中性粒细胞活化中的作用。全血与C5a孵育可增加吞噬作用，但不增加H2O2的产生。相反，添加合成PAF可显著刺激H2O2的产生，而吞噬作用并未增加。此外，在用甲醛复用的铜仿膜进行透析期间，补体活化被消除，吞噬作用不再增强，而H2O2产生的刺激作用持续存在。此外，我们还排除了膜本身在中性粒细胞活化中的特殊作用。