Antibodies to cytoskeletal components in patients undergoing long-term hemodialysis detected by a sensitive enzyme-linked immunosorbent assay (ELISA).

To date only a few contradictory reports concerning the incidence of autoantibodies in patients undergoing long-term hemodialysis exist. The aim of the present study was to investigate the sera drawn from 45 patients with chronic renal failure, 39 of them on chronic hemodialysis (duration 1-17 years). Serum samples were tested for 15 autoantibodies, no antinuclear antibodies or antibodies to extractable nuclear antigens could be detected; all sera were also negative for antibodies to dsDNA, mitochondria, gastric parietal cells and smooth muscle. In contrast a high incidence of antibodies to cytoskeletal components could be demonstrated using a sensitive enzyme-linked immunosorbent assay that employed purified antigens. Antibodies of IgG-type (IgM-type shown in brackets) were detected against cytokeratin in 51.3% (15.4%), actin in 17.9% (5.1%), desmin in 28.2% (17.9%), vimentin in 15.4% (5.1%) and tropomyosin in 12.8% (5.1%) of the sera of patients on chronic hemodialysis. No association with diagnosis, duration of hemodialysis, age or interdialytic changes of body weight and antibody titers could be found. In a control group of 82 healthy blood donors no antibodies were detected. Positive correlations of incidence of antibodies to actin, desmin, vimentin and keratin suggests polyclonal activation of immune system in patients with chronic renal failure undergoing long-term hemodialysis. The mechanism is unknown.