Tohoku University Hospital Division of Blood Purification, 1-1, Seiryo-cho, Aoba-ku, Sendai, Miyagi Prefecture, Japan.
Research Division of Chronic Kidney Disease and Dialysis Treatment, Tohoku University Hospital, Sendai, Japan.
Sci Rep. 2020 Dec 10;10(1):21747. doi: 10.1038/s41598-020-78742-z.
Biocompatibility of hemodialysis (HD) systems have been considerably improved. However, mortality and morbidity rates of patients have remained high, raising questions regarding the biocompatibility of current systems. In the present study, 70 patients on regular HD (51 males; mean age, 63 years; median duration of HD, 18 months) with high-performance membrane (polysulfone, 77%; polymethylmethacrylate, 23%) at Tohoku University Hospital were examined. Blood samples before and after HD, were subjected to measure apoptosis cells of white blood cells, plasma levels of the following molecules: myeloperoxidase (MPO), pentraxin 3 (PTX3), angiogenin, complements, and 17 cytokines. The main findings were as follows: significant decreases in leukocyte counts by dialysis, significant increases in apoptosis-positive leukocytes by dialysis (neutrophils and monocytes), and significant decrease in plasma angiogenin accompanying increase in plasma MPO and PTX3 levels, with no or only marginal changes in plasma pro-inflammatory cytokine levels and complement products by dialysis. The findings underlined the unsolved issue of bio-incompatibility of HD systems, and suggest the possible pathology of neutrophil apoptosis accompanying MPO release for the development of microinflammation in patients on HD.
血液透析（HD）系统的生物相容性已经得到了极大的改善。然而，患者的死亡率和发病率仍然很高，这引发了对当前系统生物相容性的质疑。在本研究中，我们检查了在东北大学医院接受高通量膜（聚砜，77%；聚甲基丙烯酸甲酯，23%）常规 HD 的 70 名患者（51 名男性；平均年龄 63 岁；HD 持续时间中位数为 18 个月）。在 HD 前后采集血样，以测量白细胞凋亡细胞、以下分子的血浆水平：髓过氧化物酶（MPO）、五聚蛋白 3（PTX3）、血管生成素、补体和 17 种细胞因子。主要发现如下：透析导致白细胞计数显著减少，透析导致凋亡阳性白细胞（中性粒细胞和单核细胞）显著增加，血浆血管生成素水平显著降低，同时 MPO 和 PTX3 水平升高，而透析对血浆促炎细胞因子水平和补体产物几乎没有或只有轻微影响。这些发现强调了 HD 系统生物不相容性的未解决问题，并提示 HD 患者中中性粒细胞凋亡伴随 MPO 释放可能导致微炎症的发生。
