Thylén P, Fernvik E, Lundahl J, Lins L E, Jacobson S H
Department of Internal Medicine, Karolinska Hospital, Stockholm, Sweden.
Nephron. 1996;74(2):275-82. doi: 10.1159/000189321.
We studied cell surface modulation of CD11b/CD18 and CD62L on monocytes and granulocytes, sICAM-1 concentrations and the responsiveness of cells to exogenous fMLP in patients in the intra- (0-4 h Cuprophan dialysis) and interdialytic period (5-28 h) and in healthy subjects (0-24 h). The high CD11b/CD18, low CD62L granulocyte phenotype occurred rapidly during dialysis. By contrast, CD62L increased on the subpopulation of monocytes in circulation initially during dialysis and CD11b/CD18 was mobilized much slower. In the interdialytic period, the CD62L/(CD11b/CD18) ratio was reduced up to 12 h after start of treatment on both monocytes and granulocytes. This ratio was significantly lower than in healthy subjects up to 8 h after start of treatment. The responsiveness of granulocytes to exogenous fMLP, in terms of CD11b/CD18 mobilization, was significantly reduced in patients during and after hemodialysis as compared to that on granulocytes obtained from healthy controls. Monocytes were more refractory to fMLP up to 4 h after dialysis. sICAM-1 was significantly increased in patients before dialysis as compared to controls and remained elevated and fairly stable throughout treatment and in the interdialytic period. The variation in the expression of adhesion molecules on monocytes and on granulocytes in the interdialytic period was not related to the presence of activating serum factors remaining in the circulation after treatment. Our findings emphasize the importance of including the interdialytic period in the evaluation of dialysis membrane biocompatibility, especially when effects on monocytes are of interest.
我们研究了在患者透析期间(0 - 4小时铜仿膜透析)、透析间期(5 - 28小时)以及健康受试者(0 - 24小时)中,单核细胞和粒细胞上CD11b/CD18和CD62L的细胞表面调节、可溶性细胞间黏附分子-1(sICAM-1)浓度以及细胞对外源性甲酰甲硫氨酸-亮氨酸-苯丙氨酸(fMLP)的反应性。透析过程中,粒细胞迅速出现高CD11b/CD18、低CD62L的表型。相比之下,透析开始时循环中单核细胞亚群上的CD62L最初增加,而CD11b/CD18的调动则慢得多。在透析间期,治疗开始后12小时内,单核细胞和粒细胞上的CD62L/(CD11b/CD18)比值均降低。治疗开始后长达8小时,该比值显著低于健康受试者。与从健康对照获得的粒细胞相比,患者在血液透析期间及之后,粒细胞对外源性fMLP的反应性(以CD11b/CD18调动衡量)显著降低。透析后4小时内,单核细胞对fMLP更具耐受性。与对照组相比,患者透析前sICAM-1显著升高,且在整个治疗过程及透析间期均保持升高且相当稳定。透析间期单核细胞和粒细胞上黏附分子表达的变化与治疗后循环中残留的激活血清因子的存在无关。我们的研究结果强调了在评估透析膜生物相容性时纳入透析间期的重要性,尤其是当关注对单核细胞的影响时。