Interleukin-1 beta, tumor necrosis factor, and prostaglandin E2 response after incubation of peritoneal cells and peripheral blood mononuclear cells with lipopolysaccharide.

The magnitude of response to lipopolysaccharide (LPS) by cells isolated from peritoneal dialysate (PDC) (n = 29) was compared to the response of monocytes (M) from hemodialysis (HD) patients (n = 8) and from normals (n = 9). Further studies compared monocyte (M) and PDC from 8 peritoneal dialysis (PD) patients, with adherence purification of PDC. The cells were cultured at 5 x 10(5)/ml with varying LPS concentrations for 1, 2, 8, 20 and 48 hrs. TNF was measured by L929 assay, PGE2 by RIA and Il-1 beta by ELISA. The data demonstrate a defect in the stimulated response of TNF and Il-1 beta by M from both HD and PD patients. A similar defect is also present in PDC. By contrast PGE2 response to stimulation with LPS does not differ in M from HD and normals. For TNF and PGE2 the depressed response of the PDC may be explained by the lower percentage of macrophages (M phi) if adherence purification has not been carried out. However Il-1 beta production by adherence purified M phi is significantly lower than monocytes, although greater than non-adherent cells. We describe alterations in uremic M and M phi function which may contribute to the clinically observed immune defect in uremia.