Jörres A, Jörres D, Gahl G M, Schulz E, Mahiout A
Rudolf Virchow University Clinic, Berlin-Charlottenberg, Germany.
Int J Artif Organs. 1992 Feb;15(2):84-8.
The role of cytokines in patients with chronic renal failure is currently under investigation. We therefore studied the release of leukotriene B4 (LTB4) from polymorphonuclear leukocytes (PMN) in stable dialysis patients treated with two different cellulose membranes, Cuprophan and Hemophan, a modified cellulose with less complement activation. Six patients were treated for four weeks with Cuprophan then switched to Hemophan for another four weeks. Before and after the last treatment of each period, PMN were separated from 20 ml heparinized blood by FICOLL density gradient centrifugation. Portions of 5 x 10(6) PMN were resuspended in Hanks' buffer and stimulated for 5 minutes with calcium ionophore A23187 (5 micrograms/ml). LTB4 in cell supernatants was determined by specific radioimmunoassay. PMN from dialysis patients before HD released significantly (p less than 0.01) more LTB4 than healthy donors. No significant difference between pre- and post-dialysis values was observed with Cuprophan or Hemophan dialyzers. Our data suggest that the acute effects of blood membrane interaction with either complement activating or non-activating dialyzers do not lead to changes in post-dialysis leukotriene metabolism, but leukotriene production is enhanced chronically in dialysis patients.
细胞因子在慢性肾衰竭患者中的作用目前正在研究中。因此，我们研究了使用两种不同纤维素膜（铜仿膜和血仿膜，一种补体激活较少的改良纤维素膜）进行稳定透析治疗的患者中多形核白细胞（PMN）白三烯B4（LTB4）的释放情况。6例患者先用铜仿膜治疗4周，然后改用血仿膜再治疗4周。在每个阶段的最后一次治疗前后，通过FICOLL密度梯度离心从20ml肝素化血液中分离出PMN。将5×10(6)个PMN重悬于汉克斯缓冲液中，并用钙离子载体A23187（5微克/毫升）刺激5分钟。通过特异性放射免疫测定法测定细胞上清液中的LTB4。透析前透析患者的PMN释放的LTB4明显（p<0.01）多于健康供体。使用铜仿膜或血仿膜透析器时，透析前和透析后的值之间未观察到显著差异。我们的数据表明，血液与补体激活或非激活透析器相互作用的急性效应不会导致透析后白三烯代谢的变化，但透析患者的白三烯生成长期增强。
