Chenoweth D E, Cheung A K, Henderson L W
Kidney Int. 1983 Dec;24(6):764-9. doi: 10.1038/ki.1983.225.
Measurable complement activation resulting in the formation of both C3a and C5a anaphylatoxins was observed in 12 patients undergoing maintenance dialysis treatment with cuprophan hollow fiber dialyzers. Specific radioimmunoassay measurements demonstrated that these patients displayed significantly elevated levels of C3a antigen in the venous (outflow) line of the dialyzer after only 2 min of dialysis. During hemodialysis, venous plasma C3a levels continued to increase and became maximally elevated after 15 min. Thereafter, C3a concentrations gradually declined, suggesting that the rate of complement activation abates with continued cuprophan hemodialysis. Complement activation, as judged by venous plasma C3a levels, was also temporally correlated with hemodialysis leukopenia. The factor believed to be responsible for pulmonary vascular leukosequestration, C5a, could also be detected in venous plasma, but levels of this antigen were not strikingly elevated until the later stages of dialysis. By contrast, six patients dialyzed with polyacrylonitrile dialyzers failed to exhibit hemodialysis leukopenia and displayed only very modest increases in their plasma C3a levels during the initial phases of hemodialysis. These observations provide direct evidence that anaphylatoxin formation during hemodialysis is a transient phenomenon and indicate that the biocompatibility of dialysis membranes, as reflected by their complement activating potential, may be significantly different.
在12例使用铜仿中空纤维透析器进行维持性透析治疗的患者中，观察到可测量的补体激活，导致C3a和C5a过敏毒素均形成。特异性放射免疫测定显示，这些患者在透析仅2分钟后，透析器静脉（流出）管路中的C3a抗原水平就显著升高。血液透析期间，静脉血浆C3a水平持续升高，并在15分钟后达到最高值。此后，C3a浓度逐渐下降，表明随着铜仿血液透析的持续进行，补体激活速率降低。根据静脉血浆C3a水平判断，补体激活也与血液透析白细胞减少在时间上相关。被认为是导致肺血管白细胞滞留的因素C5a，也能在静脉血浆中检测到，但该抗原水平直到透析后期才显著升高。相比之下，6例使用聚丙烯腈透析器进行透析的患者未出现血液透析白细胞减少，且在血液透析初始阶段血浆C3a水平仅出现非常轻微的升高。这些观察结果提供了直接证据，表明血液透析过程中过敏毒素的形成是一种短暂现象，并表明透析膜的生物相容性，如通过其补体激活潜能所反映的，可能存在显著差异。
