Craddock P R, Fehr J, Dalmasso A P, Brighan K L, Jacob H S
J Clin Invest. 1977 May;59(5):879-88. doi: 10.1172/JCI108710.
Acute leukopenia occurs in all patients during the first hour of hemodialysis with cellophanemembrane equipment. This transient cytopenia specifically involves granulocytes and monocytes, cells which share plasma membrane reactivity towards activated complement components. The present studies document that complement is activated during exposure of plasma to dialyzer cellophane, and that upon reinfusion of this plasma into the venous circulation, granulocyte and monocyte entrapment in the pulmonary vasculature is induced. During early dialysis, conversion of both C3 and factor B can be demonstrated in plasma as it leaves the dialyzer. Moreover, simple incubation of human plasma with dialyzer cellophane causes conversion of C3 and factor B, accompanied by depletion of total hemolytic complement and C3 but sparing of hemolytic C1. Reinfusion of autologous, cellophane-incubated plasma into rabbits produces selective granulocytopenia and monocytopenia identical to that seen in dialyzed patients. Lungs from such animals reveal striking pulmonary vessel engorgement with granulocytes. The activated complement component(s) responsible for leukostasis has an approximate molecular weight of 7,000-20,000 daltons. Since it is generated in C2-deficient plasma and is associated with factor B conversion, it is suggested that activation of complement by dialysis is predominantly through the altermative pathway.
在使用赛璐玢膜设备进行血液透析的第一个小时内，所有患者都会出现急性白细胞减少症。这种短暂的血细胞减少症特别涉及粒细胞和单核细胞，这些细胞对活化的补体成分具有相同的质膜反应性。目前的研究表明，在血浆与透析器赛璐玢接触期间补体被激活，并且当将这种血浆回输到静脉循环中时，会诱导粒细胞和单核细胞滞留于肺血管系统。在透析早期，可以证明血浆离开透析器时C3和B因子都发生了转化。此外，将人血浆与透析器赛璐玢简单孵育会导致C3和B因子转化，同时总溶血补体和C3减少，但溶血C1不受影响。将自体经赛璐玢孵育的血浆回输到兔子体内会产生与透析患者相同的选择性粒细胞减少和单核细胞减少。这些动物的肺显示出粒细胞引起的明显肺血管充血。负责白细胞淤滞的活化补体成分的分子量约为7000 - 20000道尔顿。由于它在C2缺陷血浆中产生并与B因子转化有关，因此提示透析引起的补体激活主要通过替代途径。
