Jacobs A A, Ward R A, Wellhausen S R, McLeish K R
Department of Medicine, University of Louisville, KY.
Nephron. 1989;52(2):119-24. doi: 10.1159/000185613.
Phagocytosis, H2O2 production, and C3bi receptor (CR3) expression by polymorphonuclear leukocytes (PMN) obtained from patients before, during, and after a hemodialysis treatment were evaluated by flow microfluorometry. The results were compared to changes in plasma levels of C3ades Arg and C5ades Arg. Prior to hemodialysis C3ades Arg and C5ades Arg levels, CR3 expression and phagocytosis were not different from normal controls. However, both basal and phagocytosis-induced H2O2 production were increased. C3ades Arg and C5ades Arg were increased after 15 min of dialysis; this was accompanied by transient but significant reductions in PMN count and phagocytosis and increased CR3 expression. No changes in basal or stimulated H2O2 production were observed. We conclude that PMN of hemodialysis patients are primed for an enhanced respiratory burst before dialysis is initiated. Dialysis-induced complement activation after the initiation of dialysis does not further stimulate H2O2 production or enhance the response to phagocytosis. However, complement activation may cause leukopenia and CR3 expression.
采用流式微量荧光测定法评估了在血液透析治疗前、治疗期间及治疗后从患者体内获取的多形核白细胞（PMN）的吞噬作用、过氧化氢（H2O2）生成以及C3bi受体（CR3）表达情况。将结果与血浆中C3ades Arg和C5ades Arg水平的变化进行了比较。血液透析前，C3ades Arg和C5ades Arg水平、CR3表达及吞噬作用与正常对照组无差异。然而，基础状态下以及吞噬作用诱导的H2O2生成均增加。透析15分钟后C3ades Arg和C5ades Arg增加；与此同时，PMN计数和吞噬作用出现短暂但显著的降低，而CR3表达增加。未观察到基础状态下或受刺激后的H2O2生成有变化。我们得出结论，血液透析患者的PMN在开始透析前就已被启动，以增强呼吸爆发。透析开始后透析诱导的补体激活并不会进一步刺激H2O2生成或增强对吞噬作用的反应。然而，补体激活可能会导致白细胞减少和CR3表达。
